Press Release
WASHINGTON, Nov. 30 /PRNewswire/ -- Health insurance plans are advancing the horizons of information technology (IT) on many fronts, and in the process are achieving impressive results in health care quality, service, cost, and efficiency. "Innovations in Health Information Technology," a new report from America's Health Insurance Plans (AHIP), profiles more than 40 innovations in the use of health IT that address a variety of needs in our nation's health care system with effective new solutions.
"Clearly, America's Health Insurance Plans are investing in the innovations in information technology included in our new report because they recognize the improvements that can be achieved," said AHIP President and CEO Karen Ignagni. "Advances in information technology can help ensure that the best of the U.S. health care system will also be its norm."
The health insurance plan community has a tradition of sharing information about emerging and best practices that can spur others in the field to continue to raise the bar. In addition, the industry plans to circulate the report to policymakers, colleague organizations, and providers of health care.
The companies profiled in AHIP's report have applied information technology to a wide ranging set of challenges and opportunities:
* A Florida health insurance plan located in a community with a shortage
of critical care physicians has established an electronic intensive
care unit (e-ICU) in its three participating hospitals. This advanced
technology system allows specially trained critical care physicians and
nurses to monitor ICU patients on a 24/7 basis from a remote location.
The system alerts onsite medical teams of potentially detrimental
changes so they can intervene immediately to avert crises. In its first
year of operation, the program saved lives, fewer ICU patients
experienced cardiopulmonary arrest, and the risk of mortality among ICU
patients fell.
* Three health insurance plans in Massachusetts have joined forces to
jump start the use of e-prescribing technology by physicians throughout
the state. A handheld device enables physicians to access patients/
medication histories, check for potentially harmful drug allergies and
adverse interactions, and create and renew prescriptions
electronically. The program promotes patients' safety and helps avoid
errors caused by illegible handwriting.
* A Nevada health insurance plan has implemented a digital radiology
program that capture x-rays in digital format rather than on film and
makes them immediately available for its medical group's doctors to
review and evaluate. X-ray images are accompanied by radiologists'
note, which are transcribed electronically with a voice recognition
system and stored in Word documents for easy viewing. Physicians can
access the X-rays they have ordered, along with radiologists'
assessments, within hours instead of days, thereby improving their
ability to make timely and informed treatment decisions.
Perhaps no IT initiative offers more promise or has acquired more urgency in the wake of recent events than the development and implementation of electronic personal health records (PHRs). A PHR is an electronic record of an individual's health and care that compiles information across time and providers. Today, an individual may receive care from a number of different providers in a variety of settings, and for most consumers, no system is in place to coordinate and summarize the information from these disparate health care encounters. PHRs can aggregate an individual's personal health information for them into a coherent and permanent record of care for their use.
A number of pioneering approaches to PHRs are profiled in a section of the new health IT report, looking at how health insurance plans are developing PHRs and other forms of electronic health records, and finding that they have great potential to improve health care quality, reduce costs, and increase consumer satisfaction.
Wednesday, November 30, 2005
Time to spread the burden of providing health care for all
By Massachusetts Hospital Association
Special to The Eagle-Tribune
We salute the Speaker of the House for putting his plan on the table along with that of the governor, the Senate president, and the ACT! Coalition.
Massachusetts hospitals are committed to genuine health reform that provides meaningful and affordable health insurance available for every resident of the commonwealth. We are pleased that the Speaker and the entire House leadership recognize the principle of shared responsibility among all ? individuals and businesses.
In order to have a substantial effect on reducing the number of uninsured, MassHealth coverage must be available to new groups of people. The House plan significantly expands MassHealth coverage.
Special to The Eagle-Tribune
We salute the Speaker of the House for putting his plan on the table along with that of the governor, the Senate president, and the ACT! Coalition.
Massachusetts hospitals are committed to genuine health reform that provides meaningful and affordable health insurance available for every resident of the commonwealth. We are pleased that the Speaker and the entire House leadership recognize the principle of shared responsibility among all ? individuals and businesses.
In order to have a substantial effect on reducing the number of uninsured, MassHealth coverage must be available to new groups of people. The House plan significantly expands MassHealth coverage.
InsureMe Draws on Search Technology to Advance Company
Press release
DENVER --(Business Wire)-- Nov. 29, 2005 -- InsureMe, a leading consumer-agent link for finding insurance online, is using the power of the Internet to drive visitors to their Web site and boost visibility.
InsureMe, which pioneered online insurance shopping, is using search technology to achieve higher page rankings in search engine results -- amplifying their presence among online insurance shoppers nationwide.
Popular crawler-based search engines like Google and Yahoo! create automatic search results by crawling, or "spidering" through the Web in search of pages that are relevant to the user's query. Relevant results are determined by the "spider," which visits a Web page, reads it and follows links to other pages within the site.
Every page the spider finds is then filed in the search engine's index. Similar to a library card catalogue, the index holds a copy of every page a spider reads and is updated accordingly when pages change. The search engine software then sifts through its index and selects the pages that match the user's search, which are ranked chiefly by a complex algorithm that attempts to retrieve the most relevant Web sites in relation to the user's search terms.
With more than 80% of Web traffic stemming from search engines, many companies are looking to increase their presence on the Web by integrating certain techniques into their pages in efforts to appeal to search engines.
While the algorithms used by search engines to determine a page's rank remains a closely guarded secret, providing quality content and incorporating text that can be easily scanned and categorized by spiders is a common practice among Web-savvy companies looking to ascend the ranks of search engine results.
Another key factor in achieving a high page rank in search results is the presence of inbound links. When a spider scans a Web page, it also follows any links on to the site. Essentially, inbound links attest to the page's value, thus propelling the page higher in the search engine's results page.
While the ranking processes of crawler-based search engines present certain challenges for companies looking to increase their presence online, it's great news for consumers who benefit from the constant enrichment of sites on the Web.
"While it's our goal to present visitors with the best insurance content on the Web, we also have to be sensitive to the indexing needs of the search engines," says James Omdahl, InsureMe Affiliate Manager.
"It encourages us to examine the variables affecting search results and build our sites to meet the needs of the search engines. And, as the search engines refine their ranking algorithms, we've found that higher-quality content rises to the top of the rankings. This is great news for user-focused sites like InsureMe.com."
About InsureMe
This information is brought to you by InsureMe, an Englewood, Colorado-based company that links agents nationwide with consumers shopping for insurance. Specializing in auto, home, life, long-term care and health insurance quotes, the InsureMe network provides thousands of agents with insurance leads every year. For more information, visit www.InsureMe.com.
InsureMe is a registered trademark of InsureMe corporation. All other trademarks mentioned are the property of their respective owners.
DENVER --(Business Wire)-- Nov. 29, 2005 -- InsureMe, a leading consumer-agent link for finding insurance online, is using the power of the Internet to drive visitors to their Web site and boost visibility.
InsureMe, which pioneered online insurance shopping, is using search technology to achieve higher page rankings in search engine results -- amplifying their presence among online insurance shoppers nationwide.
Popular crawler-based search engines like Google and Yahoo! create automatic search results by crawling, or "spidering" through the Web in search of pages that are relevant to the user's query. Relevant results are determined by the "spider," which visits a Web page, reads it and follows links to other pages within the site.
Every page the spider finds is then filed in the search engine's index. Similar to a library card catalogue, the index holds a copy of every page a spider reads and is updated accordingly when pages change. The search engine software then sifts through its index and selects the pages that match the user's search, which are ranked chiefly by a complex algorithm that attempts to retrieve the most relevant Web sites in relation to the user's search terms.
With more than 80% of Web traffic stemming from search engines, many companies are looking to increase their presence on the Web by integrating certain techniques into their pages in efforts to appeal to search engines.
While the algorithms used by search engines to determine a page's rank remains a closely guarded secret, providing quality content and incorporating text that can be easily scanned and categorized by spiders is a common practice among Web-savvy companies looking to ascend the ranks of search engine results.
Another key factor in achieving a high page rank in search results is the presence of inbound links. When a spider scans a Web page, it also follows any links on to the site. Essentially, inbound links attest to the page's value, thus propelling the page higher in the search engine's results page.
While the ranking processes of crawler-based search engines present certain challenges for companies looking to increase their presence online, it's great news for consumers who benefit from the constant enrichment of sites on the Web.
"While it's our goal to present visitors with the best insurance content on the Web, we also have to be sensitive to the indexing needs of the search engines," says James Omdahl, InsureMe Affiliate Manager.
"It encourages us to examine the variables affecting search results and build our sites to meet the needs of the search engines. And, as the search engines refine their ranking algorithms, we've found that higher-quality content rises to the top of the rankings. This is great news for user-focused sites like InsureMe.com."
About InsureMe
This information is brought to you by InsureMe, an Englewood, Colorado-based company that links agents nationwide with consumers shopping for insurance. Specializing in auto, home, life, long-term care and health insurance quotes, the InsureMe network provides thousands of agents with insurance leads every year. For more information, visit www.InsureMe.com.
InsureMe is a registered trademark of InsureMe corporation. All other trademarks mentioned are the property of their respective owners.
Missouri Children's Health Insurance Changes
Jefferson City, Mo. - infoZine - The Department of Social Services' Division of Medical Services announced yesterday that it will not impose 1) a thirty-day waiting period after enrollment, or 2) a six-month waiting period for coverage when families with children eligible for the State Children's Health Insurance Program fail to pay a premium and their incomes are over 150% but less than 225% of the federal poverty level (FPL).
"What this means is that families responsible for the one percent or three percent premiums will not have to wait six months to be reinstated if for some reason they fail to make their premium payment. Reinstatement will occur as quickly as possible upon receipt of payment and the appropriate verifications. This will minimize the disruption in children's health insurance coverage," said Dr. Michael Ditmore, Director of Medical Services.
The state regulation as currently written can be read to apply the thirty-day waiting period after enrollment or the six-month waiting period for coverage to families with incomes between one hundred fifty percent and two hundred twenty-five percent of the FPL if they failed to pay premiums due to SCHIP by November 30. The Division of Medical Services is preparing a proposed regulation to limit these provisions to children in families with an income of more than two hundred twenty-five percent of the FPL.
"As written, state statute is silent to the extension of the thirty-day waiting period after enrollment and the six-month waiting period for coverage for children in families with incomes between one hundred fifty percent and two hundred twenty-five percent of the federal poverty level," said Billie Waite, attorney for the Division of Medical Services. "Division of Medical Services will be making the necessary modifications to ensure that the state regulation is in precise alignment with the statutory language."
The thirty-day waiting period and the six-month waiting period for failure to pay a premium have been a part of SCHIP since its inception for families with incomes over two hundred twenty-five percent of poverty. The latter provision was designed as a deterrent to discontinuing employer sponsored coverage in favor of Medicaid.
SCHIP families formerly had co-payment responsibilities, which were dropped in favor of the premium approach under current law. The Division of Medical Services gave families from September 1 to September 30 to pay their first premium so that coverage could continue uninterrupted. If families did not pay their premium by September 30 coverage for their children stopped, but cases remained open for a sixty-day grace period. On September 1, approximately 27,000 families owed premiums for over 48,000 children. As of October 25, payments were outstanding for about 12,300 children.
The Department is reinstating coverage for these children immediately upon receipt of payment and urges families to continue to make the premium payments as quickly as possible. For a family of four with two children making about $30,000 a year, the premium is $12.00 a month per child for full health insurance coverage. After paying the premium, the family has no further out of pocket expenses. "It is not unreasonable for families with incomes at this level to bear some responsibility for the cost of their children's care. This is reasonable, affordable health care coverage and a good investment for parents and caregivers in their children's health. We certainly hope families will take advantage of this affordable coverage," Ditmore added.
"What this means is that families responsible for the one percent or three percent premiums will not have to wait six months to be reinstated if for some reason they fail to make their premium payment. Reinstatement will occur as quickly as possible upon receipt of payment and the appropriate verifications. This will minimize the disruption in children's health insurance coverage," said Dr. Michael Ditmore, Director of Medical Services.
The state regulation as currently written can be read to apply the thirty-day waiting period after enrollment or the six-month waiting period for coverage to families with incomes between one hundred fifty percent and two hundred twenty-five percent of the FPL if they failed to pay premiums due to SCHIP by November 30. The Division of Medical Services is preparing a proposed regulation to limit these provisions to children in families with an income of more than two hundred twenty-five percent of the FPL.
"As written, state statute is silent to the extension of the thirty-day waiting period after enrollment and the six-month waiting period for coverage for children in families with incomes between one hundred fifty percent and two hundred twenty-five percent of the federal poverty level," said Billie Waite, attorney for the Division of Medical Services. "Division of Medical Services will be making the necessary modifications to ensure that the state regulation is in precise alignment with the statutory language."
The thirty-day waiting period and the six-month waiting period for failure to pay a premium have been a part of SCHIP since its inception for families with incomes over two hundred twenty-five percent of poverty. The latter provision was designed as a deterrent to discontinuing employer sponsored coverage in favor of Medicaid.
SCHIP families formerly had co-payment responsibilities, which were dropped in favor of the premium approach under current law. The Division of Medical Services gave families from September 1 to September 30 to pay their first premium so that coverage could continue uninterrupted. If families did not pay their premium by September 30 coverage for their children stopped, but cases remained open for a sixty-day grace period. On September 1, approximately 27,000 families owed premiums for over 48,000 children. As of October 25, payments were outstanding for about 12,300 children.
The Department is reinstating coverage for these children immediately upon receipt of payment and urges families to continue to make the premium payments as quickly as possible. For a family of four with two children making about $30,000 a year, the premium is $12.00 a month per child for full health insurance coverage. After paying the premium, the family has no further out of pocket expenses. "It is not unreasonable for families with incomes at this level to bear some responsibility for the cost of their children's care. This is reasonable, affordable health care coverage and a good investment for parents and caregivers in their children's health. We certainly hope families will take advantage of this affordable coverage," Ditmore added.
Lawyer Among Those Arrested for Bogus Auto Insurance Claims
From LA Times
A lawyer who allegedly headed a fraud ring that staged automobile crashes and took as much as $3 million in payments from insurers for bogus claims has been arrested, along with 22 others, officials announced this morning.
Insurance Commissioner John Garamendi said Huntington Park lawyer Bernard Laufer, 52, was taken into custody Tuesday morning at his office by California Department of Insurance Fraud investigators.
Although no one was seriously injured in the scheme, one victim was forced to close his business after his truck was totaled in a collision.
"Everybody who purchases auto insurance is paying for the fraudulent costs," said Garamendi at a news conference in City of Commerce. He estimated that 25% of all insurance costs go to fraud.
The defendants face charges of insurance fraud. Drivers could be charged with assault with a deadly weapon, according to officials.
The ring focused on SUVs and commercial trucks. Two cars driven by suspects would typically box in a victim's car on a Southern California freeway, causing a collision.
According to the department, investigators received a tip in April that Humberto Carlon, 22, of La Verne, was allegedly recruiting people to participate in staged collisions. Carlon is now serving a two-year state prison sentence.
Investigators then identified Laufer, who allegedly purchased the cases from Carlon and filed the fraudulent insurance claims against the victims' insurance companies.
"Many of the suspects Carlon recruited included friends and family, who would then allegedly recruit additional suspects and bring them to Carlon," according to a written statement by the department. "Several suspects were enticed to join the ring at a church bible study group," in the Inland Empire.
Other suspects arrested in connection with the case include: Ontario residents Daniel Hernandez, 26, Karinna Valenzuela, 22, Martha Deniz, 19, Veronica Santillan, 26, and Carlos Meza, 34; Chino residents Sonia Alburto Alvarez, 35, Alberto Espinoza, 29, Jorge Covarrubias Jimenez, 31, Angelina Alverez, 56, Jorge Jimenez, 31, Cesar Salas, 29, and Sofia Hernandez, 34; Riverside residents Juan Cervantex, 24, Maria Gonzalez, 23, Ernesto Navarro, 18, and Armando Gonzalez, 22; South Gate residents Luis Alberto Lopez, 25, and Fernando Ramirez, 30; Lakewood resident Lorena Campos, 21, Bell Gardens resident Bertha Villa, 55, and Pomona resident Veronica Contreras, 26.
"It is reprehensible to put people's lives at danger in the greedy pursuit of cash," said Garamendi. "Let this be a lesson today: if you commit a scam we will pursue you, catch you, and prosecute you to the fullest extent of the law."
A lawyer who allegedly headed a fraud ring that staged automobile crashes and took as much as $3 million in payments from insurers for bogus claims has been arrested, along with 22 others, officials announced this morning.
Insurance Commissioner John Garamendi said Huntington Park lawyer Bernard Laufer, 52, was taken into custody Tuesday morning at his office by California Department of Insurance Fraud investigators.
Although no one was seriously injured in the scheme, one victim was forced to close his business after his truck was totaled in a collision.
"Everybody who purchases auto insurance is paying for the fraudulent costs," said Garamendi at a news conference in City of Commerce. He estimated that 25% of all insurance costs go to fraud.
The defendants face charges of insurance fraud. Drivers could be charged with assault with a deadly weapon, according to officials.
The ring focused on SUVs and commercial trucks. Two cars driven by suspects would typically box in a victim's car on a Southern California freeway, causing a collision.
According to the department, investigators received a tip in April that Humberto Carlon, 22, of La Verne, was allegedly recruiting people to participate in staged collisions. Carlon is now serving a two-year state prison sentence.
Investigators then identified Laufer, who allegedly purchased the cases from Carlon and filed the fraudulent insurance claims against the victims' insurance companies.
"Many of the suspects Carlon recruited included friends and family, who would then allegedly recruit additional suspects and bring them to Carlon," according to a written statement by the department. "Several suspects were enticed to join the ring at a church bible study group," in the Inland Empire.
Other suspects arrested in connection with the case include: Ontario residents Daniel Hernandez, 26, Karinna Valenzuela, 22, Martha Deniz, 19, Veronica Santillan, 26, and Carlos Meza, 34; Chino residents Sonia Alburto Alvarez, 35, Alberto Espinoza, 29, Jorge Covarrubias Jimenez, 31, Angelina Alverez, 56, Jorge Jimenez, 31, Cesar Salas, 29, and Sofia Hernandez, 34; Riverside residents Juan Cervantex, 24, Maria Gonzalez, 23, Ernesto Navarro, 18, and Armando Gonzalez, 22; South Gate residents Luis Alberto Lopez, 25, and Fernando Ramirez, 30; Lakewood resident Lorena Campos, 21, Bell Gardens resident Bertha Villa, 55, and Pomona resident Veronica Contreras, 26.
"It is reprehensible to put people's lives at danger in the greedy pursuit of cash," said Garamendi. "Let this be a lesson today: if you commit a scam we will pursue you, catch you, and prosecute you to the fullest extent of the law."
Tuesday, November 29, 2005
Medica Posts 15% Increase in Individual Product Applications in First Month
SOUTHBOROUGH, Mass.--(BUSINESS WIRE)--Nov. 29, 2005--Since launching ikaSystems' technology on September 6, 2005, hits on the Individual product portion of Medica's website have increased from 5,700 total since January 1, 2005 to almost 13,000 for the month of October alone. That's an increase of over 125%, partly due to consumer response to the online automation of Medica's Individual product line. "This is just the tip of the iceberg," says Ravi Ika, President and CEO of ikaSystems. "We are pleased with Medica's results and look forward to phasing in other ikaSystems' products of equal magnitude," he adds.
ikaSystems' powerful web-enabled Sales portal automates the entire sales cycle for Medica, whose custom solution includes online health insurance quote and proposal generation, application ability, and medical underwriting.
As expected, automating the sales cycle via ikaSystems technology has increased sales, simplified the application process, and decreased administrative costs. "We've seen a 30% increase in individual health insurance applications in the last two months (based on the previous three month average) since we've launched the Sales portal," says Mark Owen, Vice President & General Manager, Center for Healthy Aging at Medica Health Plans.
Online enrollment has reduced Medica's administrative costs significantly. "We get fewer incomplete applications, which is the biggest cost-cutting factor," says Owen. Before, with Medica's paper-based application process there were many errors--such as incorrectly calculated premiums--which added to the processing timeline. Now, Medica's administrative staff has to do less "scrubbing" to complete applications, which results in a quicker response time to Underwriting, Owen adds.
ikaSystems and Medica are currently finalizing the Underwriting portion of the Admin portal, with deployment scheduled for the beginning of 2006. "When the Admin portal is fully implemented, we expect to see a significant increase in our throughput," says Owen. "The system will deal automatically with the simple black and white accept/reject decisions; thereby, reducing the number of applications that actually need underwriter review," he adds.
ikaSystems' powerful web-enabled Sales portal automates the entire sales cycle for Medica, whose custom solution includes online health insurance quote and proposal generation, application ability, and medical underwriting.
As expected, automating the sales cycle via ikaSystems technology has increased sales, simplified the application process, and decreased administrative costs. "We've seen a 30% increase in individual health insurance applications in the last two months (based on the previous three month average) since we've launched the Sales portal," says Mark Owen, Vice President & General Manager, Center for Healthy Aging at Medica Health Plans.
Online enrollment has reduced Medica's administrative costs significantly. "We get fewer incomplete applications, which is the biggest cost-cutting factor," says Owen. Before, with Medica's paper-based application process there were many errors--such as incorrectly calculated premiums--which added to the processing timeline. Now, Medica's administrative staff has to do less "scrubbing" to complete applications, which results in a quicker response time to Underwriting, Owen adds.
ikaSystems and Medica are currently finalizing the Underwriting portion of the Admin portal, with deployment scheduled for the beginning of 2006. "When the Admin portal is fully implemented, we expect to see a significant increase in our throughput," says Owen. "The system will deal automatically with the simple black and white accept/reject decisions; thereby, reducing the number of applications that actually need underwriter review," he adds.
Rx for insurance
From the Charlotte Observer
It covers 590,000 people. It has cost taxpayers $750 million more in the past four years. And it still doesn't provide affordable family medical care for North Carolina's workers. The state health insurance plan is broken, and citizens should demand that lawmakers follow through and fix it.
North Carolina may be first in flight, but it's in the rear when it comes to health insurance for state employees and their families. What's wrong? The plan's expensive, it's out of date and it puts the state at a competitive disadvantage when luring top workers. Those things should change -- without delay.
Here's the problem. Even though managed care dominates in the private sector, North Carolina has the only state employee health insurance in the country that offers no choice beyond the traditional fee-for-service indemnity plan.
The practical effects are costly.
? Though the state pays premiums for workers and retirees, prices are higher than the market rate for spouses and families -- $480.14 a month.
? Insurance cost increases have outpaced employee raises in recent years. This year state employees got raises of 2 percent maximum. But monthly premiums for family coverage rose 12.3 percent.
? The number of enrolled retirees who incur high health care expenses is outpacing the number of young, relatively healthy workers entering the plan. That has forced the legislature to kick in money to keep the plan financially sound. Taxpayers have contributed $750 million since 2001.
Those trends can't continue. State workers deserve affordable family coverage. The state needs to be able to draw the best workers by offering top benefits. North Carolinians deserve more efficiency for their money.
The solution is not complicated. George Stokes, executive director of the state health insurance plan, has rolled out two managed-care programs based on a network of preferred provider organizations (PPOs). The details will change, but lawmakers will be asked to approve one of them in the 2006 General Assembly.
Estimates show considerable savings to both employees and taxpayers. The state's chief operating officer said North Carolina could save $460,000 for every 1 percent of the plan's members who switch to the PPO. The overall savings could be tens of millions of dollars annually.
Reform is not without obstacles. The state must find an administrator for any PPO plan. The state also plans to ask doctors and hospitals to agree to lower reimbursements for PPO patients than those now paid under the current plan. Doctors and hospitals are groups with powerful lobbies in the General Assembly. They could make any change politically difficult.
Yet there is no excuse for foot-dragging. It's past time North Carolina updated its state health insurance plan, making it flexible and affordable. That's an important piece of housekeeping on behalf of state employees -- and on behalf of all citizens, who foot the bills.
It covers 590,000 people. It has cost taxpayers $750 million more in the past four years. And it still doesn't provide affordable family medical care for North Carolina's workers. The state health insurance plan is broken, and citizens should demand that lawmakers follow through and fix it.
North Carolina may be first in flight, but it's in the rear when it comes to health insurance for state employees and their families. What's wrong? The plan's expensive, it's out of date and it puts the state at a competitive disadvantage when luring top workers. Those things should change -- without delay.
Here's the problem. Even though managed care dominates in the private sector, North Carolina has the only state employee health insurance in the country that offers no choice beyond the traditional fee-for-service indemnity plan.
The practical effects are costly.
? Though the state pays premiums for workers and retirees, prices are higher than the market rate for spouses and families -- $480.14 a month.
? Insurance cost increases have outpaced employee raises in recent years. This year state employees got raises of 2 percent maximum. But monthly premiums for family coverage rose 12.3 percent.
? The number of enrolled retirees who incur high health care expenses is outpacing the number of young, relatively healthy workers entering the plan. That has forced the legislature to kick in money to keep the plan financially sound. Taxpayers have contributed $750 million since 2001.
Those trends can't continue. State workers deserve affordable family coverage. The state needs to be able to draw the best workers by offering top benefits. North Carolinians deserve more efficiency for their money.
The solution is not complicated. George Stokes, executive director of the state health insurance plan, has rolled out two managed-care programs based on a network of preferred provider organizations (PPOs). The details will change, but lawmakers will be asked to approve one of them in the 2006 General Assembly.
Estimates show considerable savings to both employees and taxpayers. The state's chief operating officer said North Carolina could save $460,000 for every 1 percent of the plan's members who switch to the PPO. The overall savings could be tens of millions of dollars annually.
Reform is not without obstacles. The state must find an administrator for any PPO plan. The state also plans to ask doctors and hospitals to agree to lower reimbursements for PPO patients than those now paid under the current plan. Doctors and hospitals are groups with powerful lobbies in the General Assembly. They could make any change politically difficult.
Yet there is no excuse for foot-dragging. It's past time North Carolina updated its state health insurance plan, making it flexible and affordable. That's an important piece of housekeeping on behalf of state employees -- and on behalf of all citizens, who foot the bills.
How Fair Is Your Car Insurance Rate?
What comes between you and a better car insurance rate? It may not have much to do with your driving record and everything to do with your ZIP code.
Sally Russell of Lutherville wants the best auto insurance coverage at an affordable price.
Russell: "I'm a pretty good driver, knock on wood."
But that doesn't necessarily mean she'll get a good rate. We had Russell go online to search for quotes. The first question she's asked is her ZIP code. After answering additional questions, she gets a quote.
Russell: "$470."
She tries it again using the same exact information but changes the ZIP code to a Baltimore City address.
Russell: "Quite a difference for the same coverage."
Her premium jumps from $470 to $780 -- an increase of more than 60 percent.
Russell: "I don't know what to think. I'm kind of blown away by it. I'm glad I live in Baltimore County."
But we discovered car insurance rates can vary dramatically from block to block.
We checked one insurance company and found if you live in Roland Park -- the 21210 ZIP code --the rate is cheaper than if you live just a few steps away in Hampden -- the 21211 ZIP code. The difference you'd pay is $57 more a year.
The difference can be a lot more depending on your insurance company.
Bob McCarthy moved just a few blocks.
McCarthy: "We carried our stuff. We didn't bother renting a truck. It wasn't very far."
His premium almost doubled. If anything, he thought the rate would drop because he moved from this apartment with on-street parking to a home with a driveway.
McCarthy: "They kept saying you moved into a high risk area."
According to the insurance information institute, that's because accidents, theft and fraud drive rates up and most claims come from urban areas.
Carolyn Gorman, Insurance Information Institute: "We think the territorial rating is the best you can get. Admittedly it's not perfect, but it's difficult to get anything better than that."
In one scenario outlined by the Maryland Insurance Administration, a 45-year-old, married woman living in Anne Arundel County ZIP code 21401 would pay $2,900 for a family rate. In Carroll County's 21157 ZIP code, she would pay about $3,300. In Baltimore County's 21030 ZIP code, her rate would be $3,600; and in Baltimore City's 21218 ZIP code, the rate would be $5,900.
Consumers Union attorney Mark Savage said the problem is a built-in bias that makes where you live more important than how you drive.
Savage: "This is unfair. It's irrational, it's unjust, and it's a matter of economic justice."
In fact, a study published by the Abell Foundation found territorial ratings discriminatory. Low-income families and minorities are impacted the most.
Researcher Tom Waldron: "Maryland's insurance system is broken in my opinion. It's out of date and hasn't been changed in many years."
It is the state insurance commission's job to make sure insurance rates aren't excessive or discriminatory.
Waldron: "I think Maryland needs to wake up and realize there's a problem."
The state is starting to look into the issue and has set up an auto insurance task force. Maryland state Sen. Lisa Gladden is on the panel. She's also a Baltimore City resident.
Gladden: "It is unfair especially when you live on one side of the street, you get one rate and on the other you get a different rate. No justification for that at all."
But changing the way insurance companies set rates won't be easy. It's been tried before and failed. A 1988 California law required the insurance industry to depend less on ZIP codes and more on other factors like driving records.
Sally Russell of Lutherville wants the best auto insurance coverage at an affordable price.
Russell: "I'm a pretty good driver, knock on wood."
But that doesn't necessarily mean she'll get a good rate. We had Russell go online to search for quotes. The first question she's asked is her ZIP code. After answering additional questions, she gets a quote.
Russell: "$470."
She tries it again using the same exact information but changes the ZIP code to a Baltimore City address.
Russell: "Quite a difference for the same coverage."
Her premium jumps from $470 to $780 -- an increase of more than 60 percent.
Russell: "I don't know what to think. I'm kind of blown away by it. I'm glad I live in Baltimore County."
But we discovered car insurance rates can vary dramatically from block to block.
We checked one insurance company and found if you live in Roland Park -- the 21210 ZIP code --the rate is cheaper than if you live just a few steps away in Hampden -- the 21211 ZIP code. The difference you'd pay is $57 more a year.
The difference can be a lot more depending on your insurance company.
Bob McCarthy moved just a few blocks.
McCarthy: "We carried our stuff. We didn't bother renting a truck. It wasn't very far."
His premium almost doubled. If anything, he thought the rate would drop because he moved from this apartment with on-street parking to a home with a driveway.
McCarthy: "They kept saying you moved into a high risk area."
According to the insurance information institute, that's because accidents, theft and fraud drive rates up and most claims come from urban areas.
Carolyn Gorman, Insurance Information Institute: "We think the territorial rating is the best you can get. Admittedly it's not perfect, but it's difficult to get anything better than that."
In one scenario outlined by the Maryland Insurance Administration, a 45-year-old, married woman living in Anne Arundel County ZIP code 21401 would pay $2,900 for a family rate. In Carroll County's 21157 ZIP code, she would pay about $3,300. In Baltimore County's 21030 ZIP code, her rate would be $3,600; and in Baltimore City's 21218 ZIP code, the rate would be $5,900.
Consumers Union attorney Mark Savage said the problem is a built-in bias that makes where you live more important than how you drive.
Savage: "This is unfair. It's irrational, it's unjust, and it's a matter of economic justice."
In fact, a study published by the Abell Foundation found territorial ratings discriminatory. Low-income families and minorities are impacted the most.
Researcher Tom Waldron: "Maryland's insurance system is broken in my opinion. It's out of date and hasn't been changed in many years."
It is the state insurance commission's job to make sure insurance rates aren't excessive or discriminatory.
Waldron: "I think Maryland needs to wake up and realize there's a problem."
The state is starting to look into the issue and has set up an auto insurance task force. Maryland state Sen. Lisa Gladden is on the panel. She's also a Baltimore City resident.
Gladden: "It is unfair especially when you live on one side of the street, you get one rate and on the other you get a different rate. No justification for that at all."
But changing the way insurance companies set rates won't be easy. It's been tried before and failed. A 1988 California law required the insurance industry to depend less on ZIP codes and more on other factors like driving records.
Groups file suit over health-insurance payments
AUGUSTA -- Business and insurance groups filed three lawsuits Monday asking judges in Augusta and Portland to overturn $43.7 million in payments that insurers have been ordered to make to expand health-insurance coverage in Maine.
The outcome of those suits is important to thousands of Mainers. Losing some of that money would prevent the state-sponsored DirigoChoice insurance program from growing, according to Trish Riley of the Governor's Office of Health Policy and Finance. Losing the full amount would kill the program in 2006, she said. The program now insures more than 7,000 Mainers. Riley said the $43.7 million would allow DirigoChoice to cover about 3,000 people who are now on a waiting list and expand still more in the months ahead. Additionally, some of the money would pay for a state watchdog group.
The suits were filed by the Maine State Chamber of Commerce, an insurance trade group, and health plans representing auto dealers and bank-ers. The suits claim that the state insurance superintendent overstated savings that insurers have achieved from health-care reforms that Gov. John Baldacci pushed through the Legislature in 2003.
Specifically, the suits allege that some of the $43.7 million in savings recognized by Insurance Superintendent Alessandro Iuppa are theoretical or prospective, and that other savings may be real but are not attributable to Baldacci's cost-cutting efforts. In both cases, the suits say, the state should not have used those savings to calculate how much money private insurers have to contribute to DirigoChoice.
State law says savings stemming from efforts to control health-care costs are supposed to go into DirigoChoice, and that's the number that Iuppa pegged at $43.7 million on Oct. 29. The directors of the state agency that oversees DirigoChoice decided Nov. 22 to collect the full amount through assessments that will begin in January.
"We think the methodology is absolutely flawed," said Katherine Pelletreau of the Maine Association of Health Plans, which filed its suit in Cumberland County Superior Court Monday. "These are savings on paper" or savings that would have occurred without Baldacci's efforts, she said.
Pelletreau's association represents Aetna Inc., Anthem Blue Cross and Blue Shield, CIGNA HealthCare of Maine Inc. and Harvard Pilgrim Health Care. Anthem Blue Cross and Blue Shield is the private carrier for DirigoChoice.
"We contend that some of these initiatives have nothing to do with Dirigo Health," the umbrella reform plan that includes the DirigoChoice insurance program, said Kristine Ossenfort of the Maine State Chamber of Commerce, which filed suit Monday in Kennebec County Superior Court.
"It's really a matter of what should be treated as savings that stem from Dirigo Health," Ossenfort said, because those are the only savings that can be used to help pay for DirigoChoice. She said the chamber believes that totals $2.7 million, not $43.7 million.
The third suit, which was filed in Kennebec County Superior Court by trusts controlled by bankers and car dealers, raises similar issues and makes procedural arguments against the payment order.
Supporters of DirigoChoice said they were disappointed by the lawsuits.
The task of figuring out how big a dent Dirigo Health has made in health-care costs was done "under a microscope" in three separate stages that culminated in Iuppa's ruling, so the final $43.7 million figure is reliable, said Joseph Ditre of Consumers for Affordable Health Care.
"The real losers in this whole thing are those uninsured and underinsured Mainers" who rely on DirigoChoice, Ditre said.
Riley, the governor's top health-care adviser, declined comment on the specific allegations in the suits, but she said she believes Iuppa's ruling will stand up in court.
Monday's legal maneuvering was only the latest sign that Dirigo Health remains a controversial program whose fate is far from clear. The Legislature is poised to consider bills in 2006 that would rework the program, which is emerging as an early focal point of next year's gubernatorial campaign.
Baldacci, a Democrat who is seeking re-election next year, sees Dirigo Health and DirigoChoice as highlights of his first term as governor. But Republicans have their doubts. Recently, for example, GOP contender Peter Mills, a state senator from Cornville, described DirigoChoice as a risky experiment that has failed.
The outcome of those suits is important to thousands of Mainers. Losing some of that money would prevent the state-sponsored DirigoChoice insurance program from growing, according to Trish Riley of the Governor's Office of Health Policy and Finance. Losing the full amount would kill the program in 2006, she said. The program now insures more than 7,000 Mainers. Riley said the $43.7 million would allow DirigoChoice to cover about 3,000 people who are now on a waiting list and expand still more in the months ahead. Additionally, some of the money would pay for a state watchdog group.
The suits were filed by the Maine State Chamber of Commerce, an insurance trade group, and health plans representing auto dealers and bank-ers. The suits claim that the state insurance superintendent overstated savings that insurers have achieved from health-care reforms that Gov. John Baldacci pushed through the Legislature in 2003.
Specifically, the suits allege that some of the $43.7 million in savings recognized by Insurance Superintendent Alessandro Iuppa are theoretical or prospective, and that other savings may be real but are not attributable to Baldacci's cost-cutting efforts. In both cases, the suits say, the state should not have used those savings to calculate how much money private insurers have to contribute to DirigoChoice.
State law says savings stemming from efforts to control health-care costs are supposed to go into DirigoChoice, and that's the number that Iuppa pegged at $43.7 million on Oct. 29. The directors of the state agency that oversees DirigoChoice decided Nov. 22 to collect the full amount through assessments that will begin in January.
"We think the methodology is absolutely flawed," said Katherine Pelletreau of the Maine Association of Health Plans, which filed its suit in Cumberland County Superior Court Monday. "These are savings on paper" or savings that would have occurred without Baldacci's efforts, she said.
Pelletreau's association represents Aetna Inc., Anthem Blue Cross and Blue Shield, CIGNA HealthCare of Maine Inc. and Harvard Pilgrim Health Care. Anthem Blue Cross and Blue Shield is the private carrier for DirigoChoice.
"We contend that some of these initiatives have nothing to do with Dirigo Health," the umbrella reform plan that includes the DirigoChoice insurance program, said Kristine Ossenfort of the Maine State Chamber of Commerce, which filed suit Monday in Kennebec County Superior Court.
"It's really a matter of what should be treated as savings that stem from Dirigo Health," Ossenfort said, because those are the only savings that can be used to help pay for DirigoChoice. She said the chamber believes that totals $2.7 million, not $43.7 million.
The third suit, which was filed in Kennebec County Superior Court by trusts controlled by bankers and car dealers, raises similar issues and makes procedural arguments against the payment order.
Supporters of DirigoChoice said they were disappointed by the lawsuits.
The task of figuring out how big a dent Dirigo Health has made in health-care costs was done "under a microscope" in three separate stages that culminated in Iuppa's ruling, so the final $43.7 million figure is reliable, said Joseph Ditre of Consumers for Affordable Health Care.
"The real losers in this whole thing are those uninsured and underinsured Mainers" who rely on DirigoChoice, Ditre said.
Riley, the governor's top health-care adviser, declined comment on the specific allegations in the suits, but she said she believes Iuppa's ruling will stand up in court.
Monday's legal maneuvering was only the latest sign that Dirigo Health remains a controversial program whose fate is far from clear. The Legislature is poised to consider bills in 2006 that would rework the program, which is emerging as an early focal point of next year's gubernatorial campaign.
Baldacci, a Democrat who is seeking re-election next year, sees Dirigo Health and DirigoChoice as highlights of his first term as governor. But Republicans have their doubts. Recently, for example, GOP contender Peter Mills, a state senator from Cornville, described DirigoChoice as a risky experiment that has failed.
Monday, November 28, 2005
InsureMe Offers Tips for Keeping Teen Car Insurance Affordable
Press Release
Denver (PRWEB) November 28, 2005 -- Parents work hard to protect their children. But when these precious children find themselves thrust into adulthood behind the wheel of the family car, many parents discover their car insurance rates soaring along with their concerns and find that essential protection hard to find.
More than 5,000 teens ages 16 to 20 die annually in vehicle-related accidents, according to the American Academy of Pediatrics. For this reason, many car insurance companies consider drivers under 25 a higher-than-average risk. This increased risk of death and injury leads to soaring teen car insurance rates.
But if teens are willing to expend some effort and follow a few simple guidelines, parents won?t have to take away the car keys just yet.
To keep rates low, InsureMe, the leading consumer-agent link for buying insurance on the Web, recommends these tips for teens:
? Keep a Clean Driving Record
Just one DWI (driving while intoxicated) conviction can raise teen car insurance premiums above a base premium of a few hundred dollars annually for at least three years.
? Earn ?Brownie Points?
Many companies offer discounts to teens attending high school or college full-time who maintain at least a 3.0 grade point average. Insurers also offer discounts to teens who take a locally accredited driver safety course or other state-certified program. Ask your insurer about these discounts, or get information online from the National Safety Council at www.nsc.org.
? Involve Yourself in Your Community
Young people who join certain civic or community organizations (such as Eagle Scouts or Girl Scouts) may receive discounts from their teen car insurance providers. Car insurers often reward teens willing to better their communities with lower rates, since these types of teens usually pose less risk.
? Choose a Safer Car
Car insurance may cost up to 50 percent less if your teen drives a safer car, such as a Honda Civic or a Volvo. Newer model cars with airbags are the least expensive to insure, and the safest for teens to drive. Sports cars, expensive cars, high-performance cars and SUVs carry higher risk and higher teen car insurance premiums.
? Add Safety Features
Protective features such as anti-lock brakes, traction control, automatic seatbelts and side-impact airbags can reduce teen car insurance rates considerably.
? Shop Around
Agents have different programs of incentives and discounts, and by shopping around, chances are improved for finding the right discounts for a specific teen driver. The Internet provides fast and easy methods for reaching insurance agents.
A little extra attention can mean lower car insurance rates?and on-the-road protection?for the entire family.
Denver (PRWEB) November 28, 2005 -- Parents work hard to protect their children. But when these precious children find themselves thrust into adulthood behind the wheel of the family car, many parents discover their car insurance rates soaring along with their concerns and find that essential protection hard to find.
More than 5,000 teens ages 16 to 20 die annually in vehicle-related accidents, according to the American Academy of Pediatrics. For this reason, many car insurance companies consider drivers under 25 a higher-than-average risk. This increased risk of death and injury leads to soaring teen car insurance rates.
But if teens are willing to expend some effort and follow a few simple guidelines, parents won?t have to take away the car keys just yet.
To keep rates low, InsureMe, the leading consumer-agent link for buying insurance on the Web, recommends these tips for teens:
? Keep a Clean Driving Record
Just one DWI (driving while intoxicated) conviction can raise teen car insurance premiums above a base premium of a few hundred dollars annually for at least three years.
? Earn ?Brownie Points?
Many companies offer discounts to teens attending high school or college full-time who maintain at least a 3.0 grade point average. Insurers also offer discounts to teens who take a locally accredited driver safety course or other state-certified program. Ask your insurer about these discounts, or get information online from the National Safety Council at www.nsc.org.
? Involve Yourself in Your Community
Young people who join certain civic or community organizations (such as Eagle Scouts or Girl Scouts) may receive discounts from their teen car insurance providers. Car insurers often reward teens willing to better their communities with lower rates, since these types of teens usually pose less risk.
? Choose a Safer Car
Car insurance may cost up to 50 percent less if your teen drives a safer car, such as a Honda Civic or a Volvo. Newer model cars with airbags are the least expensive to insure, and the safest for teens to drive. Sports cars, expensive cars, high-performance cars and SUVs carry higher risk and higher teen car insurance premiums.
? Add Safety Features
Protective features such as anti-lock brakes, traction control, automatic seatbelts and side-impact airbags can reduce teen car insurance rates considerably.
? Shop Around
Agents have different programs of incentives and discounts, and by shopping around, chances are improved for finding the right discounts for a specific teen driver. The Internet provides fast and easy methods for reaching insurance agents.
A little extra attention can mean lower car insurance rates?and on-the-road protection?for the entire family.
Initiative backs school insurance changes
By Tim Martin
Associated Press
Frustrated by the high cost of providing health insurance for their employees, a group of southwestern Michigan school districts have joined forces in an effort to save money.
The initiative to form a regional insurance pool could become a focal point in the debate about recently introduced state legislation aimed at reducing health care costs for Michigan schools. Senate Republican supporters of new bills plan to hold hearings within the next few weeks. Their effort is supported by some labor unions but is opposed by a group affiliated with the Michigan Education Association, the state's largest teachers union.
Containing health care costs in public education has become a hot topic in the state Legislature, although so far efforts at major reform have fizzled.
In many school districts, health care coverage is the second biggest piece of the budget, trailing only employee salaries. Health insurance eats up about 15 percent of the budget in East Grand Rapids Public Schools, one of 14 districts in and near Kent County to launch a self-insurance pool in September after three years of preparation and gaining necessary approvals. The pool covers about 1,100 employees - mostly nonunion administrators - and participants say it could save about 8 percent in health care costs this year.
"With the starting of our pool, we feel we can start to contain health care costs better," said Doug Derks, an East Grand Rapids assistant superintendent. "But there could be something done to try to make the process a little easier."
Supporters say bills introduced by Republican Sens. Shirley Johnson of Troy and Wayne Kuipers of Holland would allow districts to eliminate bureaucratic hurdles associated with setting up regional pools and spark more competition among insurers. They say their plan would retain unions' bargaining rights and preserve benefits.
The legislation would establish a statewide fund to cover catastrophic claims and provide a focus on wellness and preventive care.
"The money this saves would go back into education - to hire more teachers, for pay raises, to buy textbooks or technology," said Kuipers, chairman of the Senate Education Committee. "Schools will get this money back."
But the Michigan Education Special Services Association says the legislation is unnecessary, risky and a Republican attack on the state's largest teachers union, the Michigan Education Association. MESSA, an MEA affiliate, provides plans that cover about 55 percent of the state's K-12 and community college employees.
Pooling coverage saves money on administrative costs and has other benefits that come from having more people covered in the same plan, supporters say.
But MESSA says it already provides pooling advantages in Michigan. "It's politics," Gary Fralick, a MESSA spokesman, said of the reform efforts. "I think they saw an opportunity to try and divide the house of labor."
Fralick said Republicans have been trying to damage MESSA, and by extension the MEA, for more than a decade.
But other labor groups, including the American Federation of Teachers and the International Union of Operating Engineers Local 547, support the legislation. The bills are based partly on reforms suggested by the groups this year.
The groups say MESSA will survive if its business is truly competitive. "If MESSA provides a quality product at a competitive price, MESSA will be alive and well," said David Hecker, AFT Michigan's president.
Associated Press
Frustrated by the high cost of providing health insurance for their employees, a group of southwestern Michigan school districts have joined forces in an effort to save money.
The initiative to form a regional insurance pool could become a focal point in the debate about recently introduced state legislation aimed at reducing health care costs for Michigan schools. Senate Republican supporters of new bills plan to hold hearings within the next few weeks. Their effort is supported by some labor unions but is opposed by a group affiliated with the Michigan Education Association, the state's largest teachers union.
Containing health care costs in public education has become a hot topic in the state Legislature, although so far efforts at major reform have fizzled.
In many school districts, health care coverage is the second biggest piece of the budget, trailing only employee salaries. Health insurance eats up about 15 percent of the budget in East Grand Rapids Public Schools, one of 14 districts in and near Kent County to launch a self-insurance pool in September after three years of preparation and gaining necessary approvals. The pool covers about 1,100 employees - mostly nonunion administrators - and participants say it could save about 8 percent in health care costs this year.
"With the starting of our pool, we feel we can start to contain health care costs better," said Doug Derks, an East Grand Rapids assistant superintendent. "But there could be something done to try to make the process a little easier."
Supporters say bills introduced by Republican Sens. Shirley Johnson of Troy and Wayne Kuipers of Holland would allow districts to eliminate bureaucratic hurdles associated with setting up regional pools and spark more competition among insurers. They say their plan would retain unions' bargaining rights and preserve benefits.
The legislation would establish a statewide fund to cover catastrophic claims and provide a focus on wellness and preventive care.
"The money this saves would go back into education - to hire more teachers, for pay raises, to buy textbooks or technology," said Kuipers, chairman of the Senate Education Committee. "Schools will get this money back."
But the Michigan Education Special Services Association says the legislation is unnecessary, risky and a Republican attack on the state's largest teachers union, the Michigan Education Association. MESSA, an MEA affiliate, provides plans that cover about 55 percent of the state's K-12 and community college employees.
Pooling coverage saves money on administrative costs and has other benefits that come from having more people covered in the same plan, supporters say.
But MESSA says it already provides pooling advantages in Michigan. "It's politics," Gary Fralick, a MESSA spokesman, said of the reform efforts. "I think they saw an opportunity to try and divide the house of labor."
Fralick said Republicans have been trying to damage MESSA, and by extension the MEA, for more than a decade.
But other labor groups, including the American Federation of Teachers and the International Union of Operating Engineers Local 547, support the legislation. The bills are based partly on reforms suggested by the groups this year.
The groups say MESSA will survive if its business is truly competitive. "If MESSA provides a quality product at a competitive price, MESSA will be alive and well," said David Hecker, AFT Michigan's president.
MaternityCard Provides Help for Pregnant Woman With No Maternity Insurance
Austin, Texas (PRWEB) November 28, 2005 -- MaternityCard, through its parent company Affordable Health Care Options (AHCO), is helping expectant mothers find financial relief with innovative maternity benefits and services.
With www.MaternityCard.com, AHCO offers their customers a simple means of saving substantially on the costs of having a child. Their services are aimed at those who don't have health insurance, don't qualify for government assistance, or do have health insurance but don't have coverage for the cost of having a baby. The segment of the population that falls into these categories is growing every day.
A www.MaternityCard.com client can expect to save up to 60% off of the usual and customary rates which uninsured parents are usually expected to pay to the physicians and hospitals.
With their services, there are no exclusions for pre-existing conditions, no high premiums, no co-pays or deductibles, and no lengthy claims forms to fill out. The Patient Advocacy Team assists the clients through every stage of pregnancy, contacting physicians and hospitals directly to obtain the most savings, through contracts and negotiations.
Clients save on every medical aspect of their pregnancy, including doctor visits, lab work, ultrasounds, prenatal vitamins, prescriptions, hospital stay and anesthesiologist, any complications, and post-natal care for the mother and child.
April 5, 2005, The Wall Street Journal, CHILDBIRTH FOR BARGAIN-HUNTERS, says, "Pregnant woman are by necessity and ingenuity paving the way in what is called 'consumer driven' health care." And, "a typical childbirth can run anywhere from $7,000 to $12,000." Also, www.MaternityCard.com is mentioned in the article as one of the innovative alternatives for uninsured pregnant woman.
Kelly Jones, Winnemucca, NV says that www.MaternityCard.com has been a good experience. "We found your information on the web after we found out we were pregnant before our maternity insurance kicked in. We were really nervous about all the high bills that were starting to come in, especially since we were having twins. When I finally decided to make the call, everyone was so helpful and supportive. It really made me feel more at ease knowing I had some help when I needed it. They saved me at least $9000 on one bill, and I didn't have to deal with the hospital! That was so important to me because I was able to spend more time with my new babies."
One of the founders, Angelo Feller, recently used www.MaternityCard.com for the birth of his fifth child. "I'm a pro at the delivery room paper shuffle, and this birth was the smoothest one, yet!" AHCO and www.MaternityCard.com have contracted rates with a network of over 450,000 providers, and pass those savings directly to the customers, allowing them to save much more than an uninsured individual could possibly save on their own behalf.
With www.MaternityCard.com, AHCO offers their customers a simple means of saving substantially on the costs of having a child. Their services are aimed at those who don't have health insurance, don't qualify for government assistance, or do have health insurance but don't have coverage for the cost of having a baby. The segment of the population that falls into these categories is growing every day.
A www.MaternityCard.com client can expect to save up to 60% off of the usual and customary rates which uninsured parents are usually expected to pay to the physicians and hospitals.
With their services, there are no exclusions for pre-existing conditions, no high premiums, no co-pays or deductibles, and no lengthy claims forms to fill out. The Patient Advocacy Team assists the clients through every stage of pregnancy, contacting physicians and hospitals directly to obtain the most savings, through contracts and negotiations.
Clients save on every medical aspect of their pregnancy, including doctor visits, lab work, ultrasounds, prenatal vitamins, prescriptions, hospital stay and anesthesiologist, any complications, and post-natal care for the mother and child.
April 5, 2005, The Wall Street Journal, CHILDBIRTH FOR BARGAIN-HUNTERS, says, "Pregnant woman are by necessity and ingenuity paving the way in what is called 'consumer driven' health care." And, "a typical childbirth can run anywhere from $7,000 to $12,000." Also, www.MaternityCard.com is mentioned in the article as one of the innovative alternatives for uninsured pregnant woman.
Kelly Jones, Winnemucca, NV says that www.MaternityCard.com has been a good experience. "We found your information on the web after we found out we were pregnant before our maternity insurance kicked in. We were really nervous about all the high bills that were starting to come in, especially since we were having twins. When I finally decided to make the call, everyone was so helpful and supportive. It really made me feel more at ease knowing I had some help when I needed it. They saved me at least $9000 on one bill, and I didn't have to deal with the hospital! That was so important to me because I was able to spend more time with my new babies."
One of the founders, Angelo Feller, recently used www.MaternityCard.com for the birth of his fifth child. "I'm a pro at the delivery room paper shuffle, and this birth was the smoothest one, yet!" AHCO and www.MaternityCard.com have contracted rates with a network of over 450,000 providers, and pass those savings directly to the customers, allowing them to save much more than an uninsured individual could possibly save on their own behalf.
Wednesday, November 23, 2005
Comparing Health Insurance Costs online
By S.P. DINNEN
REGISTER BUSINESS WRITER
November 23, 2005
Barbara Tillinghast couldn't afford another increase in the health insurance premium she was paying at the small print shop where she works. So she started shopping and ended up in a place known more for selling music and airplane tickets: the Internet.
Tillinghast tip-toed into the process. "I was a little apprehensive that I was going to get bombarded with other offers."
Indeed, there are pitfalls to buying insurance as an individual that group policyholders don't face. But three months later, the Urbandale mom, her husband and children have insurance in place and no complaints.
"I'm saving $70 a month, and my coverage is better," Tillinghast said.
Online insurance providers offer an alternative for workers faced with rising premiums. In Iowa, a family enrolled in a Preferred Provider Organization, or PPO, the most widespread type of workplace insurance in the state, has seen a premium increase of 65 percent since 2000, according to the study by Clive workplace benefits firm David P. Lind & Associates. Co-payments and deductibles also are up.
There are no firm figures on how many people electronically shop for health insurance. One of the major companies that hooks up insurers with consumers, California-based eHealthInsurance.com, reports that it provides around 800,000 quotes a month across the nation.
Robert S. Hurley, vice president of eHealthInsurance Inc., said an advantage of online insurance is that shopping is done anonymously, avoiding a chat with an insurance agent until the consumer is ready to proceed. Also, on most Web sites hosted by brokers, the consumer can compare dozens of coverage limits and see what the cost will be before committing to a policy.
In an industry that's not noted for pricing transparency, that cost-comparison exercise offers consumers an advantage, said Gary Claxton, vice president of Kaiser Family Foundation. But Claxton, whose organization studies health care issues, said individual policy buyers should keep in mind traps, regardless of whether they're buying online or directly from a company or its agent.
Unlike group policies available at workplaces, individuals must be in good enough shape physically to be accepted by the insurer. Barbara Tillinghast said her insurer called about a medical procedure that had been performed on her son's arm. The insurer was satisfied with her answers and issued a policy.
But insurers can apply other tests when it comes to underwriting, which the consumer often won't know beforehand.
"We have a carrier that's sticky about allergies," Hurley said. Another insurer takes a closer look at applicants it considers overweight. Hurley said his company has licensed agents on hand who can discuss these idiosyncracies with applicants who call.
Once accepted, Claxton said policyholders are placed in pools, which typically comprise people who have bought the same sort of insurance. He said insurers will sometimes allow only so many people into a pool, or block, and then close it to new entrants. As policyholders drift away, the costs to the insurer of covering that block is spread over a smaller group.
"If you're sick, you're stuck" in that dwindling block, Claxton said, because you probably won't be able to qualify for insurance with another company. He said that some insurers use this method, some don't, and "if you end up with one that does, it's a problem."
Claxton said consumers can avoid that problem by staying with a particular policy for a short term. However, they'll then have to find replacement insurance.
Cheryl Randolph, a spokeswoman for American Medical Security Life Insurance Co., said applications for electronic health insurance have risen as consumers have become more accustomed to conducting business online.
"The popularity of the Internet drives our popularity," said Randolph, whose Wisconsin-based company is licensed to sell health coverage in Iowa. She said that as demand and sales rise, the cost of delivering the policy via the Internet should drop, though she did not have figures showing how any savings might be shared among consumers and insurers.
Hurley said online policies can help address concerns over the number of uninsured Americans. He is encouraged that upwards of 40 percent of consumers who visit his Web site have previously not owned a health insurance policy, he said.
REGISTER BUSINESS WRITER
November 23, 2005
Barbara Tillinghast couldn't afford another increase in the health insurance premium she was paying at the small print shop where she works. So she started shopping and ended up in a place known more for selling music and airplane tickets: the Internet.
Tillinghast tip-toed into the process. "I was a little apprehensive that I was going to get bombarded with other offers."
Indeed, there are pitfalls to buying insurance as an individual that group policyholders don't face. But three months later, the Urbandale mom, her husband and children have insurance in place and no complaints.
"I'm saving $70 a month, and my coverage is better," Tillinghast said.
Online insurance providers offer an alternative for workers faced with rising premiums. In Iowa, a family enrolled in a Preferred Provider Organization, or PPO, the most widespread type of workplace insurance in the state, has seen a premium increase of 65 percent since 2000, according to the study by Clive workplace benefits firm David P. Lind & Associates. Co-payments and deductibles also are up.
There are no firm figures on how many people electronically shop for health insurance. One of the major companies that hooks up insurers with consumers, California-based eHealthInsurance.com, reports that it provides around 800,000 quotes a month across the nation.
Robert S. Hurley, vice president of eHealthInsurance Inc., said an advantage of online insurance is that shopping is done anonymously, avoiding a chat with an insurance agent until the consumer is ready to proceed. Also, on most Web sites hosted by brokers, the consumer can compare dozens of coverage limits and see what the cost will be before committing to a policy.
In an industry that's not noted for pricing transparency, that cost-comparison exercise offers consumers an advantage, said Gary Claxton, vice president of Kaiser Family Foundation. But Claxton, whose organization studies health care issues, said individual policy buyers should keep in mind traps, regardless of whether they're buying online or directly from a company or its agent.
Unlike group policies available at workplaces, individuals must be in good enough shape physically to be accepted by the insurer. Barbara Tillinghast said her insurer called about a medical procedure that had been performed on her son's arm. The insurer was satisfied with her answers and issued a policy.
But insurers can apply other tests when it comes to underwriting, which the consumer often won't know beforehand.
"We have a carrier that's sticky about allergies," Hurley said. Another insurer takes a closer look at applicants it considers overweight. Hurley said his company has licensed agents on hand who can discuss these idiosyncracies with applicants who call.
Once accepted, Claxton said policyholders are placed in pools, which typically comprise people who have bought the same sort of insurance. He said insurers will sometimes allow only so many people into a pool, or block, and then close it to new entrants. As policyholders drift away, the costs to the insurer of covering that block is spread over a smaller group.
"If you're sick, you're stuck" in that dwindling block, Claxton said, because you probably won't be able to qualify for insurance with another company. He said that some insurers use this method, some don't, and "if you end up with one that does, it's a problem."
Claxton said consumers can avoid that problem by staying with a particular policy for a short term. However, they'll then have to find replacement insurance.
Cheryl Randolph, a spokeswoman for American Medical Security Life Insurance Co., said applications for electronic health insurance have risen as consumers have become more accustomed to conducting business online.
"The popularity of the Internet drives our popularity," said Randolph, whose Wisconsin-based company is licensed to sell health coverage in Iowa. She said that as demand and sales rise, the cost of delivering the policy via the Internet should drop, though she did not have figures showing how any savings might be shared among consumers and insurers.
Hurley said online policies can help address concerns over the number of uninsured Americans. He is encouraged that upwards of 40 percent of consumers who visit his Web site have previously not owned a health insurance policy, he said.
Repeal excessive Dirigo tax on insurance
Mainers are facing an economic storm in the cost of heating oil this winter, and Gov. Baldacci has promised to make alleviating it the first priority of business when the Legislature returns in early January.
We legislators should confront another fiscal blizzard slated to strike Maine residents on Jan. 1.
It's the "Dirigo tax," a sneak attack on Mainers is now expected to cost a typical family an additional $300 to $400 a year for health insurance.
Mind you, this is on top of premium increases already forecast in the 15 percent range.
Health insurance has become a backbreaking expense for companies and individual consumers alike. Due to ruinous mandates imposed by state government in the early 1990s, Maine now has the second most expensive health insurance in the country.
Now we are being forced to pay even more, to subsidize the governor's "signature issue" - Dirigo Health. The Dirigo tax, incidentally, will also be used to pay for more than 4,000 people recently added to MaineCare, or Medicaid, who do not qualify for federal matching funds.
These people are totally outside the scope of Dirigo, so there is no reason to fund them with Dirigo money, but the administration plans to do so anyway.
Meanwhile, some 1,200 Dirigo Choice enrollees have already dropped out, prompting Dirigo's managers to award a grant to the Muskie School to discover why people are leaving the taxpayer-subsidized insurance program.
Known officially as the savings offset payment, the Dirigo tax supposedly represents savings to Maine's health system. In theory, insurers would enjoy lower costs because Dirigo, by covering previously uninsured people, would reduce the amount of charity work performed by hospitals, physicians and other providers. (Those costs are currently "shifted" to people paying for private coverage.)
The insurers, in turn, are supposed to reimburse Dirigo for those savings to further fund the program. Initially, the Dirigo Health Agency claimed the savings were $233 million over the past year. The DHA board reduced that to $136 million. And state Superintendent of Insurance Alessandro Iuppa recently ruled that savings actually amounted to only $43.7 million.
Now, in a negotiating atmosphere turned sharp and bitter, health insurance companies are arguing strenuously there have been no savings at all - certainly none that can be attributed to Dirigo.
Who's right? Who knows? But if the estimates can range from $233 million down to $43.7 million, any estimate of savings is dubious. Regardless, the superintendent's decision will stand - insurers will be forced to pay as much as $43.7 million.
But insurance industry officials, claiming they cannot "absorb" the fee, say they will pass it on to customers as higher premiums. Correctly sensing that the "pass through" will inflame voters and erode support for his cornerstone program, the governor called a press conference on Nov. 3 where he heatedly denounced the Dirigo tax.
"The country is watching," the governor declared. "This is unacceptable. Period."
The governor, however, has little control over the insurance companies. And as they see it, business is business. The tax, said a Cigna spokeswoman, "is going to pave the way for increased health insurance costs in the state, which will result in some Maine people losing their health insurance."
In light of these disturbing developments, it is time to repeal the Dirigo tax and perhaps find another way to fund the program. If the tax is unacceptable to the governor, it's clearly going to be unacceptable to Mainers, who will rightfully ask how the governor expects to lower the cost of health insurance by imposing a new tax on it.
The $300 or $400 Dirigo tax on a family would pay for a tank of heating oil. It would pay for winter coats and boots for their kids. There is no justification for forcing citizens to pay that much money for a program that is of zero value to them.
Politically, of course, the tax is a loser. Most folks haven't paid attention to the workings of Dirigo. But they will be furious when they learn that this scheme is going to cost them big time, especially when the incessant Dirigo commercials on radio and TV keep telling them that the program is such a raving success.
Nor will many legislators enjoy facing angry constituents demanding to know how this fiasco could have happened. How could they defend such a thing?
I believe most legislators would vote to terminate this tax, for fear that voters would retaliate next November. We may find out when 2006 rolls around.
We legislators should confront another fiscal blizzard slated to strike Maine residents on Jan. 1.
It's the "Dirigo tax," a sneak attack on Mainers is now expected to cost a typical family an additional $300 to $400 a year for health insurance.
Mind you, this is on top of premium increases already forecast in the 15 percent range.
Health insurance has become a backbreaking expense for companies and individual consumers alike. Due to ruinous mandates imposed by state government in the early 1990s, Maine now has the second most expensive health insurance in the country.
Now we are being forced to pay even more, to subsidize the governor's "signature issue" - Dirigo Health. The Dirigo tax, incidentally, will also be used to pay for more than 4,000 people recently added to MaineCare, or Medicaid, who do not qualify for federal matching funds.
These people are totally outside the scope of Dirigo, so there is no reason to fund them with Dirigo money, but the administration plans to do so anyway.
Meanwhile, some 1,200 Dirigo Choice enrollees have already dropped out, prompting Dirigo's managers to award a grant to the Muskie School to discover why people are leaving the taxpayer-subsidized insurance program.
Known officially as the savings offset payment, the Dirigo tax supposedly represents savings to Maine's health system. In theory, insurers would enjoy lower costs because Dirigo, by covering previously uninsured people, would reduce the amount of charity work performed by hospitals, physicians and other providers. (Those costs are currently "shifted" to people paying for private coverage.)
The insurers, in turn, are supposed to reimburse Dirigo for those savings to further fund the program. Initially, the Dirigo Health Agency claimed the savings were $233 million over the past year. The DHA board reduced that to $136 million. And state Superintendent of Insurance Alessandro Iuppa recently ruled that savings actually amounted to only $43.7 million.
Now, in a negotiating atmosphere turned sharp and bitter, health insurance companies are arguing strenuously there have been no savings at all - certainly none that can be attributed to Dirigo.
Who's right? Who knows? But if the estimates can range from $233 million down to $43.7 million, any estimate of savings is dubious. Regardless, the superintendent's decision will stand - insurers will be forced to pay as much as $43.7 million.
But insurance industry officials, claiming they cannot "absorb" the fee, say they will pass it on to customers as higher premiums. Correctly sensing that the "pass through" will inflame voters and erode support for his cornerstone program, the governor called a press conference on Nov. 3 where he heatedly denounced the Dirigo tax.
"The country is watching," the governor declared. "This is unacceptable. Period."
The governor, however, has little control over the insurance companies. And as they see it, business is business. The tax, said a Cigna spokeswoman, "is going to pave the way for increased health insurance costs in the state, which will result in some Maine people losing their health insurance."
In light of these disturbing developments, it is time to repeal the Dirigo tax and perhaps find another way to fund the program. If the tax is unacceptable to the governor, it's clearly going to be unacceptable to Mainers, who will rightfully ask how the governor expects to lower the cost of health insurance by imposing a new tax on it.
The $300 or $400 Dirigo tax on a family would pay for a tank of heating oil. It would pay for winter coats and boots for their kids. There is no justification for forcing citizens to pay that much money for a program that is of zero value to them.
Politically, of course, the tax is a loser. Most folks haven't paid attention to the workings of Dirigo. But they will be furious when they learn that this scheme is going to cost them big time, especially when the incessant Dirigo commercials on radio and TV keep telling them that the program is such a raving success.
Nor will many legislators enjoy facing angry constituents demanding to know how this fiasco could have happened. How could they defend such a thing?
I believe most legislators would vote to terminate this tax, for fear that voters would retaliate next November. We may find out when 2006 rolls around.
Aetna Introduces New Health Insurance Options for Individuals and Their Families in Florida
Aetna (NYSE:AET) will launch health plans for individuals and their families in Florida, effective December 15, as announced earlier today at the Florida Governor's Cabinet Meeting. The plans are designed to provide affordable, comprehensive health coverage options for individuals and their families. In addition, Aetna is offering a voluntary dental benefit with these new plans.
"Aetna is committed to addressing the health insurance needs of the growing uninsured and under-insured population," said Laurie Brubaker, Aetna's national general manager for Individual Markets. "In Florida, there are more than 3.2 million people - or 19 percent of the population - who are uninsured."(1)
"We also are dedicated to meeting the health benefits needs of individuals who directly purchase health care for themselves and their family members," Brubaker added. "Our plans are designed to address unique needs during particular stages in life such as graduating from college, getting married, raising a family, becoming a sole proprietor, being between jobs or retiring early."
"We are pleased that Aetna has taken the initiative to offer plans for individuals and their families in Florida," said Kevin M. McCarty, commissioner, Florida Office of Insurance Regulation. "Aetna has a strong national brand and a growing presence in this state. The addition of these plans will provide Florida residents greater choice and flexibility in finding health care plans that appropriately address their needs."
New Plans Offer Broad Choices
Aetna is offering individuals and their families several standard plans, effective December 15. All of the plans offer members the freedom to go directly to any doctor, hospital or health care professional - including specialists - for covered services. If a member chooses a health care professional from Aetna's extensive network of participating physicians and hospitals, out-of-pocket costs will be lower.
All Florida plans also feature coverage for routine checkups and preventive care, specialty care, hospitalization and surgery, diagnostic testing and emergency care, subject to applicable copayments, coinsurance and deductibles. In addition, there are no in-network claim forms, and no referrals are required for members to see specialists. Some of the plans also include prescription drug coverage, subject to a deductible, copayments and calendar-year maximum.
Value Plans, HSA-Compatible Plans and Dental Plan Available
For those people who wish to purchase more affordable plans, there are "Value" plans which offer members similar benefits to the standard plans but have lower premium payments. In exchange for lower premiums, members must reach their annual deductible payments for doctor's office visits to be covered.
Aetna is also offering High-Deductible plans that are compatible with the Aetna HealthFund(R) Health Savings Account (HSA). The plans offer members lower premiums in exchange for higher annual deductibles. Members can take advantage of a flexible health benefits plan paired with an HSA. HSAs are tax-advantaged accounts used to pay for qualified medical expenses. HSA contributions are tax deductible and earn interest tax free. HSAs are portable, and unused balances can be carried forward from year to year, making them a strong value for consumers.
Members have the option to enroll in the Florida Dental PPO Max Plan at the time of their medical election. The Dental PPO Max Plan allows members to receive quality dental care from participating dentists and nonparticipating dentists. Participating dentists have agreed to provide certain services at a negotiated rate, which means members generally pay lower out-of-pocket costs.
"We are very excited that Aetna will now be offering health insurance plans for individuals and their families in Florida," said Wes Fischer, president of The Health Insurance Store, a Kissimmee-based independent agency specializing in health insurance and employee benefits programs. "We value, as do our clients, health insurance companies that offer multiple product lines, such as group plans, Medicare plans and plans for individuals and their families. A majority of our clients are familiar with Aetna, and we believe there will be strong consumer interest in these new individual plan options."
Additional Services Included
In addition to plan benefits, through the Vision One(R)(2) discount program, Fitness Program and Alternative Health Care Programs, members may access discounted rates from certain providers for products and services available to the general public. The Vision One program offers special member discounts on eye care products and services at participating optical centers. The Fitness Program provides special membership rates at participating fitness clubs contracted with Global Fit(3) and discounts on certain equipment. The Alternative Health Care Programs offer reduced rates on alternative therapies for members, including visits to chiropractors, acupuncturists, nutritional counselors and massage therapists. Members can also save on over-the-counter vitamins and nutritional supplements through the Vitamin Advantage(TM) program.
In addition to Florida, Aetna plans for individuals and their families are currently being sold directly to consumers or through independent insurance agents and brokers in Arizona, California, Connecticut, Delaware, Georgia, Illinois, Maryland, Ohio, Pennsylvania, Texas, Virginia and Washington, D.C. Additional information about Aetna's plans for individuals and their families is available at www.aetna.com/members/individuals/ or by calling 1-800-MY-HEALTH or your insurance agent.
As one of the nation's leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.65 million medical members, 13.03 million dental members, 9.34 million pharmacy members and 13.68 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 700,000 health care professionals, including over 418,000 primary care and specialist doctors and 4,231 hospitals. For more information, please visit www.aetna.com. (Figures as of September 30, 2005)
(1) Urban Institute and Kaiser Commission on Medicaid and the
Uninsured estimates based on pooled March 2003 and 2004 Current
Population Surveys, www.statehealthfacts.org. Accessed November
21, 2005.
(2) Vision One is a registered trademark of Cole Managed Vision.
(3) Global Fit is a trademark of Global Affiliates, Inc.
"Aetna is committed to addressing the health insurance needs of the growing uninsured and under-insured population," said Laurie Brubaker, Aetna's national general manager for Individual Markets. "In Florida, there are more than 3.2 million people - or 19 percent of the population - who are uninsured."(1)
"We also are dedicated to meeting the health benefits needs of individuals who directly purchase health care for themselves and their family members," Brubaker added. "Our plans are designed to address unique needs during particular stages in life such as graduating from college, getting married, raising a family, becoming a sole proprietor, being between jobs or retiring early."
"We are pleased that Aetna has taken the initiative to offer plans for individuals and their families in Florida," said Kevin M. McCarty, commissioner, Florida Office of Insurance Regulation. "Aetna has a strong national brand and a growing presence in this state. The addition of these plans will provide Florida residents greater choice and flexibility in finding health care plans that appropriately address their needs."
New Plans Offer Broad Choices
Aetna is offering individuals and their families several standard plans, effective December 15. All of the plans offer members the freedom to go directly to any doctor, hospital or health care professional - including specialists - for covered services. If a member chooses a health care professional from Aetna's extensive network of participating physicians and hospitals, out-of-pocket costs will be lower.
All Florida plans also feature coverage for routine checkups and preventive care, specialty care, hospitalization and surgery, diagnostic testing and emergency care, subject to applicable copayments, coinsurance and deductibles. In addition, there are no in-network claim forms, and no referrals are required for members to see specialists. Some of the plans also include prescription drug coverage, subject to a deductible, copayments and calendar-year maximum.
Value Plans, HSA-Compatible Plans and Dental Plan Available
For those people who wish to purchase more affordable plans, there are "Value" plans which offer members similar benefits to the standard plans but have lower premium payments. In exchange for lower premiums, members must reach their annual deductible payments for doctor's office visits to be covered.
Aetna is also offering High-Deductible plans that are compatible with the Aetna HealthFund(R) Health Savings Account (HSA). The plans offer members lower premiums in exchange for higher annual deductibles. Members can take advantage of a flexible health benefits plan paired with an HSA. HSAs are tax-advantaged accounts used to pay for qualified medical expenses. HSA contributions are tax deductible and earn interest tax free. HSAs are portable, and unused balances can be carried forward from year to year, making them a strong value for consumers.
Members have the option to enroll in the Florida Dental PPO Max Plan at the time of their medical election. The Dental PPO Max Plan allows members to receive quality dental care from participating dentists and nonparticipating dentists. Participating dentists have agreed to provide certain services at a negotiated rate, which means members generally pay lower out-of-pocket costs.
"We are very excited that Aetna will now be offering health insurance plans for individuals and their families in Florida," said Wes Fischer, president of The Health Insurance Store, a Kissimmee-based independent agency specializing in health insurance and employee benefits programs. "We value, as do our clients, health insurance companies that offer multiple product lines, such as group plans, Medicare plans and plans for individuals and their families. A majority of our clients are familiar with Aetna, and we believe there will be strong consumer interest in these new individual plan options."
Additional Services Included
In addition to plan benefits, through the Vision One(R)(2) discount program, Fitness Program and Alternative Health Care Programs, members may access discounted rates from certain providers for products and services available to the general public. The Vision One program offers special member discounts on eye care products and services at participating optical centers. The Fitness Program provides special membership rates at participating fitness clubs contracted with Global Fit(3) and discounts on certain equipment. The Alternative Health Care Programs offer reduced rates on alternative therapies for members, including visits to chiropractors, acupuncturists, nutritional counselors and massage therapists. Members can also save on over-the-counter vitamins and nutritional supplements through the Vitamin Advantage(TM) program.
In addition to Florida, Aetna plans for individuals and their families are currently being sold directly to consumers or through independent insurance agents and brokers in Arizona, California, Connecticut, Delaware, Georgia, Illinois, Maryland, Ohio, Pennsylvania, Texas, Virginia and Washington, D.C. Additional information about Aetna's plans for individuals and their families is available at www.aetna.com/members/individuals/ or by calling 1-800-MY-HEALTH or your insurance agent.
As one of the nation's leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.65 million medical members, 13.03 million dental members, 9.34 million pharmacy members and 13.68 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 700,000 health care professionals, including over 418,000 primary care and specialist doctors and 4,231 hospitals. For more information, please visit www.aetna.com. (Figures as of September 30, 2005)
(1) Urban Institute and Kaiser Commission on Medicaid and the
Uninsured estimates based on pooled March 2003 and 2004 Current
Population Surveys, www.statehealthfacts.org. Accessed November
21, 2005.
(2) Vision One is a registered trademark of Cole Managed Vision.
(3) Global Fit is a trademark of Global Affiliates, Inc.
Tuesday, November 22, 2005
Doctors worried about health insurance merger
Associated Press
DENVER - Doctors warned the state insurance commissioner on Monday that the proposed merger of Colorado- and California-based health insurance companies could threaten physicians' bargaining power and their ability to control patient care.
UnitedHealth Group Inc. has proposed merging with Cypress, Calif.-based PacifiCare Health Systems Inc., creating the second largest health insurance company in the nation.
The $8.1 billion merger, which is expected to close by the end of the year, would affect people in 10 states and has been approved by regulators in six of them.
Dr. Richard May, president of the Colorado Medical Society, said that state would be most affected by the merger because UnitedHealth and PacifiCare make up 23 percent of the health insurance business here.
"When an HMO owns enough of your practice to control it, they can dictate the terms," said May, an orthopedic surgeon.
He said Colorado should force UnitedHealth to guarantee that it won't raise premiums and cut payments to doctors to pay for the merger.
Doctors and consumer groups in California have expressed similar concerns.
Dr. Reed Tuckson, a senior vice president for Minnetonka, Minn.-based UnitedHealth, said the company has invested in technology, including electronic patient records and physician progress reports, which will help improve service. He said the company is committed to working with doctors to improve care.
State insurance regulators say they expect the merger will decrease competition but that bargaining clout and advances in technology would help keep health care costs down.
Under Colorado law, the four largest health insurers cannot have more than 75 percent of the market. If the merger is approved, 60 percent of the commercial market would be held by two companies - United and Anthem.
DENVER - Doctors warned the state insurance commissioner on Monday that the proposed merger of Colorado- and California-based health insurance companies could threaten physicians' bargaining power and their ability to control patient care.
UnitedHealth Group Inc. has proposed merging with Cypress, Calif.-based PacifiCare Health Systems Inc., creating the second largest health insurance company in the nation.
The $8.1 billion merger, which is expected to close by the end of the year, would affect people in 10 states and has been approved by regulators in six of them.
Dr. Richard May, president of the Colorado Medical Society, said that state would be most affected by the merger because UnitedHealth and PacifiCare make up 23 percent of the health insurance business here.
"When an HMO owns enough of your practice to control it, they can dictate the terms," said May, an orthopedic surgeon.
He said Colorado should force UnitedHealth to guarantee that it won't raise premiums and cut payments to doctors to pay for the merger.
Doctors and consumer groups in California have expressed similar concerns.
Dr. Reed Tuckson, a senior vice president for Minnetonka, Minn.-based UnitedHealth, said the company has invested in technology, including electronic patient records and physician progress reports, which will help improve service. He said the company is committed to working with doctors to improve care.
State insurance regulators say they expect the merger will decrease competition but that bargaining clout and advances in technology would help keep health care costs down.
Under Colorado law, the four largest health insurers cannot have more than 75 percent of the market. If the merger is approved, 60 percent of the commercial market would be held by two companies - United and Anthem.
City considering trust to manage health insurance
CNHI News Service
Annual costs have increased in double digits
By Carol Cole
Transcript Staff Writer
The City of Norman is considering establishing a health insurance trust to manage the burgeoning expense of employee health benefits.
Municipal employees' health insurance costs have increased in the double digits annually the past several years, with costs going up 18 percent for fiscal year 2005, and 13 percent the year before. The increases have strained the city budget, with salaries and benefits accounting for about 70 percent of the budget.
"At this rate, it's going to be double in five years," said Ward 1 councilmember Bob Thompson at the City Council's budget retreat Saturday morning.
A trust could be formed by the city manager on an administrative basis.
Union and non-union municipal employees would manage the proposed trust, choosing how best to spend trust funds for employee insurance.
"Unions don't trust the city to run it," said Mayor Harold Haralson. "Set up a trust and let them run it."
Ward 8 councilmember Doug Cubberley works with employees on their health insurance committee.
"Everybody recognizes that the train is coming quickly down the track and we are in the middle of the track," Cubberley said. "The benefit plan that we have in today's market is unrealistic."
The city is self-insured and legally obligated to pay all claims. In recent years, employees have begun to pay a portion of the costs of health insurance.
The health committee has proposed a three-tiered plan, with one of the plans being the current one.
Finance Director Anthony Francisco said the city is losing about $100,000 a month on insurance claims over what is budgeted.
"The health insurance is not enough to cover claims right now," he said.
If the trust were created, the city's $5 million reserve for self insurance would go in. Another $1.6 million would be required to further shore up the reserves.
"Just to get it on a firm footing," Francisco said.
Where that additional funding would come from is yet to be determined.
Benefit planners consulting the city have said if health insurance was managed well, increases could be held down to about 9 percent and some cities have brought increases down in the 7 to 8 percent range.
The trust would be set up similar to the Norman Employees Retirement System Board, Francisco said.
The big question is whether the three unions that represent the police, fire and many other municipal employees would agree to participate.
"I don't think we're being unreasonable to ask unions to step up to the plate and help find a solution," said Ward 2 councilmember Richard Stawicki.
The city has lost in arbitration twice in the past few years, including granting a 5.5 percent raise for salaries and related benefits for the firefighter's union, which was matched for all municipal employees.
"I think we have been fiscally responsible and the arbitrator ends up rewriting our budget," said Ward 6 councilmember David Hopper.
The city has a policy of holding 8 percent of its fund balances in reserve for unanticipated operational demands such as overtime needed in case of a natural disaster like a tornado or ice storm or below-target revenues. Reserves are not close to that amount, which keeps eroding as expenditures exceed the budget.
Ward 4 councilmember Cindy Rosenthal said the city has two options.
"We get cooperation from our employees to solve the problem or we cut people," Rosenthal said.
Annual costs have increased in double digits
By Carol Cole
Transcript Staff Writer
The City of Norman is considering establishing a health insurance trust to manage the burgeoning expense of employee health benefits.
Municipal employees' health insurance costs have increased in the double digits annually the past several years, with costs going up 18 percent for fiscal year 2005, and 13 percent the year before. The increases have strained the city budget, with salaries and benefits accounting for about 70 percent of the budget.
"At this rate, it's going to be double in five years," said Ward 1 councilmember Bob Thompson at the City Council's budget retreat Saturday morning.
A trust could be formed by the city manager on an administrative basis.
Union and non-union municipal employees would manage the proposed trust, choosing how best to spend trust funds for employee insurance.
"Unions don't trust the city to run it," said Mayor Harold Haralson. "Set up a trust and let them run it."
Ward 8 councilmember Doug Cubberley works with employees on their health insurance committee.
"Everybody recognizes that the train is coming quickly down the track and we are in the middle of the track," Cubberley said. "The benefit plan that we have in today's market is unrealistic."
The city is self-insured and legally obligated to pay all claims. In recent years, employees have begun to pay a portion of the costs of health insurance.
The health committee has proposed a three-tiered plan, with one of the plans being the current one.
Finance Director Anthony Francisco said the city is losing about $100,000 a month on insurance claims over what is budgeted.
"The health insurance is not enough to cover claims right now," he said.
If the trust were created, the city's $5 million reserve for self insurance would go in. Another $1.6 million would be required to further shore up the reserves.
"Just to get it on a firm footing," Francisco said.
Where that additional funding would come from is yet to be determined.
Benefit planners consulting the city have said if health insurance was managed well, increases could be held down to about 9 percent and some cities have brought increases down in the 7 to 8 percent range.
The trust would be set up similar to the Norman Employees Retirement System Board, Francisco said.
The big question is whether the three unions that represent the police, fire and many other municipal employees would agree to participate.
"I don't think we're being unreasonable to ask unions to step up to the plate and help find a solution," said Ward 2 councilmember Richard Stawicki.
The city has lost in arbitration twice in the past few years, including granting a 5.5 percent raise for salaries and related benefits for the firefighter's union, which was matched for all municipal employees.
"I think we have been fiscally responsible and the arbitrator ends up rewriting our budget," said Ward 6 councilmember David Hopper.
The city has a policy of holding 8 percent of its fund balances in reserve for unanticipated operational demands such as overtime needed in case of a natural disaster like a tornado or ice storm or below-target revenues. Reserves are not close to that amount, which keeps eroding as expenditures exceed the budget.
Ward 4 councilmember Cindy Rosenthal said the city has two options.
"We get cooperation from our employees to solve the problem or we cut people," Rosenthal said.
Monday, November 21, 2005
THE COSTS AND BENEFITS OF INDIVIDUAL HEALTH INSURANCE PLANS
As the number of uninsured Americans has reached 45.8 million, the importance of knowing how much consumers are willing to pay and the benefits they receive for individual health insurance plans continues to increase. A new eHealthInsurance report outlines the cost and benefits of individual health insurance plans.
According to researchers:
Individual policyholders pay, on average, $148 per month for major medical coverage; family policyholders pay an average monthly premium of $331, or $110 per covered member, based on the average of 3.0 members per plan.
Among individuals with major medical plans, women pay a higher average monthly premium than men ($160 vs. $135), as well as across each age group; however, within plans sold to families, the average monthly premium is higher for plans whose primary policy holder is a man.
The average monthly cost to insure a child on his own is $89.
The range of average monthly premiums across the United States falls between $98 for Michigan residents and $379 for New York residents; this represents a monthly disparity of $281, or $3,372 per year.
About 60 percent of major medical plans sold to individuals have a deductible of $2,000 or less, while 35 percent have a deductible of $500 or less; among family plans, 50 percent have a deductible of $2,000 or less.
Furthermore, short-term policyholders pay an average monthly premium of $78 for individual coverage and $192 for family coverage, while nearly 74 percent of short-term individual plan holders are under the age of 35, with the largest group (40 percent) between the ages of 25 and 34.
Source: "The Cost and Benefits of Individual Health Insurance Plans," eHealthInsurance, November 9, 2005.
According to researchers:
Individual policyholders pay, on average, $148 per month for major medical coverage; family policyholders pay an average monthly premium of $331, or $110 per covered member, based on the average of 3.0 members per plan.
Among individuals with major medical plans, women pay a higher average monthly premium than men ($160 vs. $135), as well as across each age group; however, within plans sold to families, the average monthly premium is higher for plans whose primary policy holder is a man.
The average monthly cost to insure a child on his own is $89.
The range of average monthly premiums across the United States falls between $98 for Michigan residents and $379 for New York residents; this represents a monthly disparity of $281, or $3,372 per year.
About 60 percent of major medical plans sold to individuals have a deductible of $2,000 or less, while 35 percent have a deductible of $500 or less; among family plans, 50 percent have a deductible of $2,000 or less.
Furthermore, short-term policyholders pay an average monthly premium of $78 for individual coverage and $192 for family coverage, while nearly 74 percent of short-term individual plan holders are under the age of 35, with the largest group (40 percent) between the ages of 25 and 34.
Source: "The Cost and Benefits of Individual Health Insurance Plans," eHealthInsurance, November 9, 2005.
Industry Warns of N.J. Auto Insurance Hikes If Court Ruling on Lawsuits Stands
An insurance industry group is warning that New Jersey auto insurance rates could increase due to a state Supreme Court ruling that makes it easier for accident victims to sue.
A study commissioned by Safe Choices for NJ Drivers found the average premium could rise by as much as $182, or an increase of between 9 and 14 percent.
The June 14 Supreme Court ruling allows people who suffer permanent injuries in auto accidents to sue over pain and suffering, even if their injuries don't meet a so-called "serious life impact" test.
The high court shocked the industry in June when it held that state lawmakers did not carry over the "serious life impact" test that limits lawsuits when they reformed the car insurance system in 1998.
The insurance industry has urged lawmakers to amend the law to make it clear that the "serious life impact" test is still in effect.
But Assemblyman Neil Cohen, chairman of the Assembly Financial Institutions and Insurance Committee, dismissed the industry study as a scare tactic.
"This is, 'The sky's falling,' and it isn't falling,'' Cohen, D-Union, told The Star-Ledger of Newark, adding there is "no chance of passing anything at all'' in the Legislature to reverse the court ruling.
Jaimee Gilmartin, a spokeswoman for the Department of Banking and Insurance, said the department has seen no evidence that the decision is causing financial problems for insurers.
"To this point, there hasn't been any indication of a drastic impact, or any impact on the market and on insurance rates,'' she said. "It's way too soon to tell.''
Bernard Flynn, general counsel and senior vice president for New Jersey Manufacturers Insurance Co., said higher premiums are inevitable unless the ruling is undone.
"It's not going to happen overnight, but it will happen in time,'' he said. "The door has been opened to minor injury lawsuits. More lawsuits mean higher costs for New Jersey drivers.''
In DiProspero v. Penn, the high court's justices on June 14 unanimously ruled that the so-called "serious life impact" test that was applied under the previous verbal threshold to limit when injured claimants could sue for non-economic damages does not apply under the current law, the Automobile Insurance Cost Reduction Act (AICRA) passed in 1998.
In reviewing the history, intent and language of the current statute, the court determined that state lawmakers did not intend to carry forward the life impact test when they enacted AICRA. New legislation would be required to do this, the justices held.
The life impact test, first applied in Oswin v. Shaw in 1992, made it more difficult for motorists to sue. The Oswin court concluded that in addition to proving that an injury fit into one of nine statutory injury categories of the verbal threshold, the accident victim also had to prove the injury resulted in a "serious life impact."
"The Supreme Court has effectively gutted the verbal threshold and potentially opened up the flood gates for litigation in non-serious injury cases," stated David Snyder, American Insurance Association vice president and assistant general counsel, last June after the ruling was issued. "This ruling wipes out many of the possible savings realized by the nine-out-of-ten drivers who chose to receive discounted premiums in return for limiting their ability to sue for pain and suffering in minor injury cases."
Last week, a state appeals panel cited the June decision in ruling that a lower court must reconsider the case of a woman who sued after an accident in which she suffered bone fractures. The appeals panel said, even though the fractures were not of the most serious nature, the bone breaks still may have resulted in permanent injury.
According to the National Association of Insurance Commissioners, New Jersey drivers paid a premium of $1,188 on average in 2003. That was the highest in the nation.
A study commissioned by Safe Choices for NJ Drivers found the average premium could rise by as much as $182, or an increase of between 9 and 14 percent.
The June 14 Supreme Court ruling allows people who suffer permanent injuries in auto accidents to sue over pain and suffering, even if their injuries don't meet a so-called "serious life impact" test.
The high court shocked the industry in June when it held that state lawmakers did not carry over the "serious life impact" test that limits lawsuits when they reformed the car insurance system in 1998.
The insurance industry has urged lawmakers to amend the law to make it clear that the "serious life impact" test is still in effect.
But Assemblyman Neil Cohen, chairman of the Assembly Financial Institutions and Insurance Committee, dismissed the industry study as a scare tactic.
"This is, 'The sky's falling,' and it isn't falling,'' Cohen, D-Union, told The Star-Ledger of Newark, adding there is "no chance of passing anything at all'' in the Legislature to reverse the court ruling.
Jaimee Gilmartin, a spokeswoman for the Department of Banking and Insurance, said the department has seen no evidence that the decision is causing financial problems for insurers.
"To this point, there hasn't been any indication of a drastic impact, or any impact on the market and on insurance rates,'' she said. "It's way too soon to tell.''
Bernard Flynn, general counsel and senior vice president for New Jersey Manufacturers Insurance Co., said higher premiums are inevitable unless the ruling is undone.
"It's not going to happen overnight, but it will happen in time,'' he said. "The door has been opened to minor injury lawsuits. More lawsuits mean higher costs for New Jersey drivers.''
In DiProspero v. Penn, the high court's justices on June 14 unanimously ruled that the so-called "serious life impact" test that was applied under the previous verbal threshold to limit when injured claimants could sue for non-economic damages does not apply under the current law, the Automobile Insurance Cost Reduction Act (AICRA) passed in 1998.
In reviewing the history, intent and language of the current statute, the court determined that state lawmakers did not intend to carry forward the life impact test when they enacted AICRA. New legislation would be required to do this, the justices held.
The life impact test, first applied in Oswin v. Shaw in 1992, made it more difficult for motorists to sue. The Oswin court concluded that in addition to proving that an injury fit into one of nine statutory injury categories of the verbal threshold, the accident victim also had to prove the injury resulted in a "serious life impact."
"The Supreme Court has effectively gutted the verbal threshold and potentially opened up the flood gates for litigation in non-serious injury cases," stated David Snyder, American Insurance Association vice president and assistant general counsel, last June after the ruling was issued. "This ruling wipes out many of the possible savings realized by the nine-out-of-ten drivers who chose to receive discounted premiums in return for limiting their ability to sue for pain and suffering in minor injury cases."
Last week, a state appeals panel cited the June decision in ruling that a lower court must reconsider the case of a woman who sued after an accident in which she suffered bone fractures. The appeals panel said, even though the fractures were not of the most serious nature, the bone breaks still may have resulted in permanent injury.
According to the National Association of Insurance Commissioners, New Jersey drivers paid a premium of $1,188 on average in 2003. That was the highest in the nation.
Health insurance: mandatory in Massachusetts?
By Sara Miller Llana | Staff writer of The Christian Science Monitor
BOSTON ? For thousands of families here struggling to make ends meet, the difficult decision of whether to buy health insurance may soon get easier: They won't have a choice.
Under two major proposals that aim to cover the estimated half million uninsured in Massachusetts, the state would require all residents who can afford it to purchase some type of individual plan or face penalties, such as losing their driver's licenses.
Massachusetts joins a growing number of states grappling with how to expand coverage at a time when employers are pulling back benefits.
But its call for an "individual mandate" is among the most ambitious - and controversial - healthcare reform plans in the country. If passed, its impact could be far- reaching, experts say.
"This is the first time this idea is real and live before a state and legislature," says Robert Blendon, a professor of health policy and management at the Harvard School of Public Health in Boston. "We have entered an age when there is more of a sense that there should be individual responsibility for your life and your family," he says, "that you owe it to your community to have coverage."
Under two separate plans, one proposed by Republican Gov. Mitt Romney, the other approved by the House, insurance companies would offer lower-cost plans, estimated at $200 a month. Residents making up to $28,710 could receive state subsidies that could further lower that premium. Many analysts say that the individual mandate should be considered only after expanding Medicaid or making premiums more affordable - something Massachusetts is also tackling.
Under the House plan, which requires employers to provide insurance or face a payroll tax, residents could lose driver's licenses for not carrying coverage. A third plan approved by the Senate also expands coverage but does not include an individual mandate. The bills will be considered for compromise in conference committee as early as this week.
While each plan is distinct, they share many similarities, and experts applaud the bipartisan ideals they reflect. "There have been two dominant approaches" nationwide, says Alan Weil, executive director of the National Academy for State Health Policy. In general, conservatives support market-based approaches; Democrats want to expand the role of government.
The proposals in Massachusetts may have found common ground. But the political response has yet to fully take shape, analysts warn. "On the one hand, it can sound punitive ... and the libertarian right sees this as big government. The left is worried about mandating people to do something they can't afford to do," says Mr. Weil. "It could be a nice middle ground, or it could be attacked on both sides."
Some residents have balked at the prospect of an individual mandate. Some people don't use traditional medicine for religious or personal reasons; others say they can't afford it.
Michael Craven, a hair stylist in Boston's South End who faces out-of-pocket expenses for a recent emergency room visit and who has forgone other treatment, would like health insurance.
But he disagrees with a mandate, particularly with government deciding where people's money should go. "Some people need a car more than insurance," he says.
Mr. Craven moved to Boston from Syracuse, N.Y., and is launching his own hair business. "Insurance is not my top priority right now. Day-to-day living is, like food," he says. "I have to build up my business before I can afford it."
Some view the mandate with caution, voicing concern over the efficacy of stripped-down policies with high premiums. Questions remain over how "affordability" will be defined.
States have been skeptical of both employer and individual mandates, as they can be viewed as tax hikes. "The fear with individual mandates is that you drive people out of state," says Howard Berliner, a professor of health policy at Milano, the New School for Management and Urban Policy in New York. "Essentially it's a tax no matter how it gets worked out."
But he, and many others, say that given stagnation on healthcare at the federal level, they are willing to watch this experiment. "The individual mandate is not perfect, but I would much prefer in New York that we had that than just a growing number without insurance at all," he says.
If the individual mandate passes, it could steer national dialogue. "If a major bill passes in Massachusetts, it would be viewed as some model that should appear in the next presidential debate," says Professor Blendon, of Harvard. Then again, "If it collapses, people will say, 'There isn't a stomach for [a healthcare overhaul], even in a state like Massachusetts.' "
BOSTON ? For thousands of families here struggling to make ends meet, the difficult decision of whether to buy health insurance may soon get easier: They won't have a choice.
Under two major proposals that aim to cover the estimated half million uninsured in Massachusetts, the state would require all residents who can afford it to purchase some type of individual plan or face penalties, such as losing their driver's licenses.
Massachusetts joins a growing number of states grappling with how to expand coverage at a time when employers are pulling back benefits.
But its call for an "individual mandate" is among the most ambitious - and controversial - healthcare reform plans in the country. If passed, its impact could be far- reaching, experts say.
"This is the first time this idea is real and live before a state and legislature," says Robert Blendon, a professor of health policy and management at the Harvard School of Public Health in Boston. "We have entered an age when there is more of a sense that there should be individual responsibility for your life and your family," he says, "that you owe it to your community to have coverage."
Under two separate plans, one proposed by Republican Gov. Mitt Romney, the other approved by the House, insurance companies would offer lower-cost plans, estimated at $200 a month. Residents making up to $28,710 could receive state subsidies that could further lower that premium. Many analysts say that the individual mandate should be considered only after expanding Medicaid or making premiums more affordable - something Massachusetts is also tackling.
Under the House plan, which requires employers to provide insurance or face a payroll tax, residents could lose driver's licenses for not carrying coverage. A third plan approved by the Senate also expands coverage but does not include an individual mandate. The bills will be considered for compromise in conference committee as early as this week.
While each plan is distinct, they share many similarities, and experts applaud the bipartisan ideals they reflect. "There have been two dominant approaches" nationwide, says Alan Weil, executive director of the National Academy for State Health Policy. In general, conservatives support market-based approaches; Democrats want to expand the role of government.
The proposals in Massachusetts may have found common ground. But the political response has yet to fully take shape, analysts warn. "On the one hand, it can sound punitive ... and the libertarian right sees this as big government. The left is worried about mandating people to do something they can't afford to do," says Mr. Weil. "It could be a nice middle ground, or it could be attacked on both sides."
Some residents have balked at the prospect of an individual mandate. Some people don't use traditional medicine for religious or personal reasons; others say they can't afford it.
Michael Craven, a hair stylist in Boston's South End who faces out-of-pocket expenses for a recent emergency room visit and who has forgone other treatment, would like health insurance.
But he disagrees with a mandate, particularly with government deciding where people's money should go. "Some people need a car more than insurance," he says.
Mr. Craven moved to Boston from Syracuse, N.Y., and is launching his own hair business. "Insurance is not my top priority right now. Day-to-day living is, like food," he says. "I have to build up my business before I can afford it."
Some view the mandate with caution, voicing concern over the efficacy of stripped-down policies with high premiums. Questions remain over how "affordability" will be defined.
States have been skeptical of both employer and individual mandates, as they can be viewed as tax hikes. "The fear with individual mandates is that you drive people out of state," says Howard Berliner, a professor of health policy at Milano, the New School for Management and Urban Policy in New York. "Essentially it's a tax no matter how it gets worked out."
But he, and many others, say that given stagnation on healthcare at the federal level, they are willing to watch this experiment. "The individual mandate is not perfect, but I would much prefer in New York that we had that than just a growing number without insurance at all," he says.
If the individual mandate passes, it could steer national dialogue. "If a major bill passes in Massachusetts, it would be viewed as some model that should appear in the next presidential debate," says Professor Blendon, of Harvard. Then again, "If it collapses, people will say, 'There isn't a stomach for [a healthcare overhaul], even in a state like Massachusetts.' "
Friday, November 18, 2005
Auto insurance in New Jersey likely to climb
Associated Press
TRENTON
An insurance industry study claims New Jersey's car insurance rates could increase due to a state Supreme Court ruling making it easier for accident victims to sue.
The study commissioned by Safe Choices for NJ Drivers, an industry interest group, found the average premium could rise by as much as $182, or an increase of between 9 and 14 percent.
A Supreme Court ruling in June allows people who suffer permanent injuries in car accidents to sue over pain and suffering, even if their injuries are minor. The insurance industry wants state lawmakers to amend the law to allow such lawsuits only in cases of serious bodily injury.
Jaimee Gilmartin, a spokeswoman for the state Department of Banking and Insurance, said the department has seen no evidence that the court decision is causing financial problems for insurers.
The National Association of Insurance Commissioners has found New Jersey drivers paid $1,188 on average in 2003.
That was the highest in the nation.
A state appeals panel cited the June decision Thursday in ruling that a lower court must reconsider the case of a woman who sued after an accident in which she suffered bone fractures. The appeals panel said, even though the fractures were not of the most serious nature -- all which fall under the state law protecting accident victim lawsuits -- the bone breaks still may have resulted in permanent injury.
TRENTON
An insurance industry study claims New Jersey's car insurance rates could increase due to a state Supreme Court ruling making it easier for accident victims to sue.
The study commissioned by Safe Choices for NJ Drivers, an industry interest group, found the average premium could rise by as much as $182, or an increase of between 9 and 14 percent.
A Supreme Court ruling in June allows people who suffer permanent injuries in car accidents to sue over pain and suffering, even if their injuries are minor. The insurance industry wants state lawmakers to amend the law to allow such lawsuits only in cases of serious bodily injury.
Jaimee Gilmartin, a spokeswoman for the state Department of Banking and Insurance, said the department has seen no evidence that the court decision is causing financial problems for insurers.
The National Association of Insurance Commissioners has found New Jersey drivers paid $1,188 on average in 2003.
That was the highest in the nation.
A state appeals panel cited the June decision Thursday in ruling that a lower court must reconsider the case of a woman who sued after an accident in which she suffered bone fractures. The appeals panel said, even though the fractures were not of the most serious nature -- all which fall under the state law protecting accident victim lawsuits -- the bone breaks still may have resulted in permanent injury.
Peter Jennings Reporting: 'Breakdown -- America's Health Insurance Crisis'
Today in the United States there are an estimated 46 million people without health insurance. That's nearly one in six ? and the numbers continue to grow.
In the last documentary reported before his death, Peter Jennings reveals how the breakdown of the country's health insurance system threatens almost every American and all areas of American life: family, business and community. Who's to blame? It's not as simple as you think.
"Peter Jennings Reporting: Breakdown ? America's Health Insurance Crisis" will air Thursday, Dec. 15 at 10 p.m. EST on the ABC Television Network with a special introduction by ABC News anchor Charles Gibson.
"Over the course of Peter's long career at ABC News he made more than 60 prime-time documentaries, many of them covering public health issues. He had planned for this broadcast to be the first of a series confronting the problems in the American health-care system ? a subject he believed was critical to all Americans," said Tom Yellin, executive producer of Peter Jennings Reporting.
"Peter conducted most of the interviews for 'Breakdown' in the months before he learned he had lung cancer," Yellin continued. "The broadcast was written and edited while he underwent treatment. Peter's voice was not strong enough to narrate the program, but, as you will see, it is still very much Peter Jennings Reporting."
"Peter Jennings Reporting: Breakdown ? America's Health Insurance Crisis" is produced by Keith Summa. Tom Yellin is the executive producer of Peter Jennings Reporting.
In the last documentary reported before his death, Peter Jennings reveals how the breakdown of the country's health insurance system threatens almost every American and all areas of American life: family, business and community. Who's to blame? It's not as simple as you think.
"Peter Jennings Reporting: Breakdown ? America's Health Insurance Crisis" will air Thursday, Dec. 15 at 10 p.m. EST on the ABC Television Network with a special introduction by ABC News anchor Charles Gibson.
"Over the course of Peter's long career at ABC News he made more than 60 prime-time documentaries, many of them covering public health issues. He had planned for this broadcast to be the first of a series confronting the problems in the American health-care system ? a subject he believed was critical to all Americans," said Tom Yellin, executive producer of Peter Jennings Reporting.
"Peter conducted most of the interviews for 'Breakdown' in the months before he learned he had lung cancer," Yellin continued. "The broadcast was written and edited while he underwent treatment. Peter's voice was not strong enough to narrate the program, but, as you will see, it is still very much Peter Jennings Reporting."
"Peter Jennings Reporting: Breakdown ? America's Health Insurance Crisis" is produced by Keith Summa. Tom Yellin is the executive producer of Peter Jennings Reporting.
Thursday, November 17, 2005
Are Allstate's new auto insurance promises too good to be true?
Accident forgiveness, auto replacement value available, for a price
Thursday, November 17, 2005
By Patricia Sabatini, Pittsburgh Post-Gazette
Worried that your auto insurance bill will zoom if you file an accident claim? What about demolishing your brand new car and discovering you are thousands of dollars in the hole because your insurance covers only the car's depreciated value?
Allstate Insurance wants to calm your fears. Pennsylvania's third largest auto insurer has been plastering billboards and blanketing the airwaves with promises of accident forgiveness, meaning the company won't raise your rates in an at-fault accident, plus a new car if yours is wrecked.
Should you bite?
As you might expect, the goodies will cost you, so you'll want to read the fine print to know exactly what you are buying.
The offerings are part of Allstate's new "your choice auto" program available in Pennsylvania and 20 other states. The Northbrook, Ill.-based insurer expects the program to be rolled out nationwide, excluding California, by the end of April.
Allstate said it developed the program in response to surveys that showed customers wanted more flexibility in the type of coverage they buy, leading it to develop a range of premium options.
Under the most expensive level of coverage, which costs an average of about 15 percent more than a standard policy, an Allstate customer can have multiple accidents forgiven and, for safe driving, earn money off the collision deductible and premium payments.
For about 7 percent more than standard coverage, a customer can have one accident forgiven every three years and earn safe-driving credits toward the deductible.
The forgiveness feature has been popular with parents of teenage drivers, Allstate spokesman George Nolan said, in part because the program lets customers buy the coverage without the typical waiting period required by other insurers.
For example, State Farm, the state's largest auto insurer, requires a clean driving record of at least three years before ignoring one accident. No. 2 Erie Insurance offers the same break as State Farm and, for customers who go 15 years without an accident, promises never to impose an accident surcharge.
Under Allstate's standard policy, motorists generally can have one accident waived after five years of safe driving.
The replacement value coverage doesn't come with the new premium packages but must be added on for an additional 3 percent charge. The replacement coverage can not be tacked on to standard coverage.
Upgrading from a standard policy to the top premium package plus replacement coverage would cost a customer roughly 18 percent more, or an additional $180 on a $1,000 premium.
Under the replacement option, if you wreck your new car, the company will replace it with a new one of the same make and model, or, if that's not available, a new vehicle of similar size and class.
Your vehicle is considered "new" for only the first three years. In addition, you must request the extra coverage within one year of buying the vehicle. If you add the option when your car is 11 months old, for example, you would have two years and one month left of eligible coverage.
Most insurers will reimburse policyholders for only the depreciated, or book value, of a totaled car. For example, your 3-year-old Honda Accord may be worth only $18,000 even though you bought it for $25,000. If you demolished it, you'd have to make up the rest if you wanted a new car.
Neither State Farm nor Erie offers replacement value coverage.
A spokesman for Erie said the insurer was considering offering it, but for only those cars less than a year old.
Bob Hunter, director of insurance for the Consumer Federation of America, said he liked the idea of giving consumers more options, but said he wasn't sure Allstate's replacement coverage was worth the extra cost, especially since it is available to only those customers who buy the more expensive premium packages.
"Personally, I wouldn't pay for it," Mr. Hunter said.
"If I have a new car, and I have an accident a week later, most likely they are going to get me a new car anyway. They are supposed to make you whole. I would hold out and say I want a new car."
Mr. Hunter said the best way for consumers to cut their auto insurance bills was to compare quotes from a number of insurers because prices vary widely.
In Allegheny County, average premiums per vehicle for a sample driver choosing the "limited tort" option, which limits the right to sue for pain and suffering in an accident, range from $542 to $3,063 a year at Allstate, and from $762 to $1,801 at State Farm, according to the Pennsylvania Insurance Department Web site, www.insurance.state.pa.us. (The range takes into account different rating territories within the county.)
At Geico, an insurer that sells policies directly instead of through agents, average premiums under the limited tort option in Allegheny County range from $500 to $1,055.
"Shopping is very important in the auto insurance business," Mr. Hunter said. "There usually is a big difference between companies."
Thursday, November 17, 2005
By Patricia Sabatini, Pittsburgh Post-Gazette
Worried that your auto insurance bill will zoom if you file an accident claim? What about demolishing your brand new car and discovering you are thousands of dollars in the hole because your insurance covers only the car's depreciated value?
Allstate Insurance wants to calm your fears. Pennsylvania's third largest auto insurer has been plastering billboards and blanketing the airwaves with promises of accident forgiveness, meaning the company won't raise your rates in an at-fault accident, plus a new car if yours is wrecked.
Should you bite?
As you might expect, the goodies will cost you, so you'll want to read the fine print to know exactly what you are buying.
The offerings are part of Allstate's new "your choice auto" program available in Pennsylvania and 20 other states. The Northbrook, Ill.-based insurer expects the program to be rolled out nationwide, excluding California, by the end of April.
Allstate said it developed the program in response to surveys that showed customers wanted more flexibility in the type of coverage they buy, leading it to develop a range of premium options.
Under the most expensive level of coverage, which costs an average of about 15 percent more than a standard policy, an Allstate customer can have multiple accidents forgiven and, for safe driving, earn money off the collision deductible and premium payments.
For about 7 percent more than standard coverage, a customer can have one accident forgiven every three years and earn safe-driving credits toward the deductible.
The forgiveness feature has been popular with parents of teenage drivers, Allstate spokesman George Nolan said, in part because the program lets customers buy the coverage without the typical waiting period required by other insurers.
For example, State Farm, the state's largest auto insurer, requires a clean driving record of at least three years before ignoring one accident. No. 2 Erie Insurance offers the same break as State Farm and, for customers who go 15 years without an accident, promises never to impose an accident surcharge.
Under Allstate's standard policy, motorists generally can have one accident waived after five years of safe driving.
The replacement value coverage doesn't come with the new premium packages but must be added on for an additional 3 percent charge. The replacement coverage can not be tacked on to standard coverage.
Upgrading from a standard policy to the top premium package plus replacement coverage would cost a customer roughly 18 percent more, or an additional $180 on a $1,000 premium.
Under the replacement option, if you wreck your new car, the company will replace it with a new one of the same make and model, or, if that's not available, a new vehicle of similar size and class.
Your vehicle is considered "new" for only the first three years. In addition, you must request the extra coverage within one year of buying the vehicle. If you add the option when your car is 11 months old, for example, you would have two years and one month left of eligible coverage.
Most insurers will reimburse policyholders for only the depreciated, or book value, of a totaled car. For example, your 3-year-old Honda Accord may be worth only $18,000 even though you bought it for $25,000. If you demolished it, you'd have to make up the rest if you wanted a new car.
Neither State Farm nor Erie offers replacement value coverage.
A spokesman for Erie said the insurer was considering offering it, but for only those cars less than a year old.
Bob Hunter, director of insurance for the Consumer Federation of America, said he liked the idea of giving consumers more options, but said he wasn't sure Allstate's replacement coverage was worth the extra cost, especially since it is available to only those customers who buy the more expensive premium packages.
"Personally, I wouldn't pay for it," Mr. Hunter said.
"If I have a new car, and I have an accident a week later, most likely they are going to get me a new car anyway. They are supposed to make you whole. I would hold out and say I want a new car."
Mr. Hunter said the best way for consumers to cut their auto insurance bills was to compare quotes from a number of insurers because prices vary widely.
In Allegheny County, average premiums per vehicle for a sample driver choosing the "limited tort" option, which limits the right to sue for pain and suffering in an accident, range from $542 to $3,063 a year at Allstate, and from $762 to $1,801 at State Farm, according to the Pennsylvania Insurance Department Web site, www.insurance.state.pa.us. (The range takes into account different rating territories within the county.)
At Geico, an insurer that sells policies directly instead of through agents, average premiums under the limited tort option in Allegheny County range from $500 to $1,055.
"Shopping is very important in the auto insurance business," Mr. Hunter said. "There usually is a big difference between companies."
Excessive Health Insurance Regulation Leads to High Costs
It?s a problem that vexes policymakers in both parties: reducing the large number of Americans who lack health insurance. At any given time, the Census Bureau estimates, about 15 percent of the total population lacks health coverage.
Many argue for greater government intervention in health care. How ironic, since government policy, particularly excessive regulatory intervention, prices many Americans out of coverage and thus contributes to the high numbers of uninsured.
Examples abound of how health insurance regulations have increased prices and disrupted insurance markets in many states. One common regulation is known as guaranteed-issue laws. These laws make it impossible for insurance companies to reject anyone who applies for health insurance. This sounds nice in theory, but it has costs that can price individuals and families out of the market.
Why? Because in states with guaranteed-issue laws, insurers are forced to provide coverage for people with pre-existing medical conditions, so they raise premiums on everyone else to cover these costs.
Plus, individuals in these states will often wait until they?re ill before purchasing the insurance. This raises premiums further. Worse, many insurers quit offering insurance in states with guaranteed-issue laws, and the lack of competition results in still-higher prices and fewer choices for consumers.
Another set of regulations with negative consequences is community-rating laws, which limit the extent to which insurers can charge different prices to different individuals. There are a variety of community-rating laws, ranging from ?modified community rating? to strict community rating, and the strictness also varies.
In practice, the insurance companies, under these rules, are required to charge healthy and unhealthy people relatively similar premiums. This sounds nice, too, but these laws can have an impact similar to guaranteed-issue laws.
That?s especially the case in states with strict community-rating laws. In those states, the low premiums typically won?t generate sufficient revenue to cover higher-risk individuals. As a result, health-insurance companies end up raising prices on both healthy and unhealthy individuals, resulting in higher costs for everyone. Several states, including Massachusetts, New York, Kentucky, West Virginia, Vermont and New Hampshire, have seen premiums skyrocket after community-rating or guaranteed-issue laws were imposed.
Insurance is regulated in countless other ways. Many states require that all insurance plans cover a variety of providers and benefits, ranging from chiropractors and infertility treatments to acupuncture and wigs. To varying degrees, these rules increase prices as well.
Some states also limit the ability of health care plans to exclude providers. Other states give subscribers the right to go to a specialist without a referral from a primary physician. Still others hold insurance companies liable for harm done to enrollees. All of these regulations effectively raise prices.
A study I recently completed for The Heritage Foundation shows that each of these regulations boosts health insurance premiums by statistically significant margins. A consumer in a state with heavy regulation could pay up to $100 more a month ($1,200 a year) than a consumer in a low-regulation state for an identical individual health insurance plan.
But, some will say, relatively few Americans buy insurance on their own, so these regulations don?t cause much harm. It should be noted, however, that today the ?non-group? market is often a market of last resort, largely consisting of those without access to employer-sponsored insurance. Therefore, the cost of its premiums likely affects whether many of these Americans can afford to purchase health insurance.
If they are serious about reducing the number of uninsured in their states, state legislators should review their insurance rules, repeal those that imposes higher costs than the benefits they are supposed to deliver, or at least modify them to reduce health care costs on individuals and families.
Meanwhile, Congress can help. Rep. John Shadegg, R-Ariz., has introduced the Health Care Choice Act that would allow individuals and families in high cost states to buy more affordable health insurance from carriers regulated in other states. As a result, individuals and families living in states where excessive insurance regulations have driven up the cost of coverage could then be free to purchase insurance elsewhere.
State insurance regulations are supposed to protect consumers and prevent unfair business practices, and many do. Still, regulations always pose tradeoffs, and it is evident that many regulations were adopted without giving careful thought to their relative costs and benefits. State officials need to engage in the much needed debate over these tradeoffs, and determine how much health insurance regulation they are willing to impose at the cost of pricing even more individuals and families out of coverage.
Many argue for greater government intervention in health care. How ironic, since government policy, particularly excessive regulatory intervention, prices many Americans out of coverage and thus contributes to the high numbers of uninsured.
Examples abound of how health insurance regulations have increased prices and disrupted insurance markets in many states. One common regulation is known as guaranteed-issue laws. These laws make it impossible for insurance companies to reject anyone who applies for health insurance. This sounds nice in theory, but it has costs that can price individuals and families out of the market.
Why? Because in states with guaranteed-issue laws, insurers are forced to provide coverage for people with pre-existing medical conditions, so they raise premiums on everyone else to cover these costs.
Plus, individuals in these states will often wait until they?re ill before purchasing the insurance. This raises premiums further. Worse, many insurers quit offering insurance in states with guaranteed-issue laws, and the lack of competition results in still-higher prices and fewer choices for consumers.
Another set of regulations with negative consequences is community-rating laws, which limit the extent to which insurers can charge different prices to different individuals. There are a variety of community-rating laws, ranging from ?modified community rating? to strict community rating, and the strictness also varies.
In practice, the insurance companies, under these rules, are required to charge healthy and unhealthy people relatively similar premiums. This sounds nice, too, but these laws can have an impact similar to guaranteed-issue laws.
That?s especially the case in states with strict community-rating laws. In those states, the low premiums typically won?t generate sufficient revenue to cover higher-risk individuals. As a result, health-insurance companies end up raising prices on both healthy and unhealthy individuals, resulting in higher costs for everyone. Several states, including Massachusetts, New York, Kentucky, West Virginia, Vermont and New Hampshire, have seen premiums skyrocket after community-rating or guaranteed-issue laws were imposed.
Insurance is regulated in countless other ways. Many states require that all insurance plans cover a variety of providers and benefits, ranging from chiropractors and infertility treatments to acupuncture and wigs. To varying degrees, these rules increase prices as well.
Some states also limit the ability of health care plans to exclude providers. Other states give subscribers the right to go to a specialist without a referral from a primary physician. Still others hold insurance companies liable for harm done to enrollees. All of these regulations effectively raise prices.
A study I recently completed for The Heritage Foundation shows that each of these regulations boosts health insurance premiums by statistically significant margins. A consumer in a state with heavy regulation could pay up to $100 more a month ($1,200 a year) than a consumer in a low-regulation state for an identical individual health insurance plan.
But, some will say, relatively few Americans buy insurance on their own, so these regulations don?t cause much harm. It should be noted, however, that today the ?non-group? market is often a market of last resort, largely consisting of those without access to employer-sponsored insurance. Therefore, the cost of its premiums likely affects whether many of these Americans can afford to purchase health insurance.
If they are serious about reducing the number of uninsured in their states, state legislators should review their insurance rules, repeal those that imposes higher costs than the benefits they are supposed to deliver, or at least modify them to reduce health care costs on individuals and families.
Meanwhile, Congress can help. Rep. John Shadegg, R-Ariz., has introduced the Health Care Choice Act that would allow individuals and families in high cost states to buy more affordable health insurance from carriers regulated in other states. As a result, individuals and families living in states where excessive insurance regulations have driven up the cost of coverage could then be free to purchase insurance elsewhere.
State insurance regulations are supposed to protect consumers and prevent unfair business practices, and many do. Still, regulations always pose tradeoffs, and it is evident that many regulations were adopted without giving careful thought to their relative costs and benefits. State officials need to engage in the much needed debate over these tradeoffs, and determine how much health insurance regulation they are willing to impose at the cost of pricing even more individuals and families out of coverage.
Wednesday, November 16, 2005
Publication details fines, complaints against AZ health insurers
Jodie Snyder
The Arizona Republic
Nov. 14, 2005 12:00 AM
Arizonans can find out more details about their health insurers, thanks to a new state publication.
The Arizona Department of Insurance has released a report listing fines and complaints filed against health insurers. It also lists the number of times consumers have filed appeals against insurers' decisions.
The report looks at the performance of 27 insurers representing 75 percent of Arizona's health insurance market.
Consumers can learn:
? Of the major health insurers, United Healthcare of Arizona has the highest number of complaints per enrollee. Other smaller companies have even higher complaint ratios. They include Fortis Insurance Co., (now known as Time Insurance Co.) and Mega Life and Health Insurance Co.
? Of the major health insurers, Humana Health Plan agrees with consumers' appeals more than any other insurer. Smaller insurers such as Mega tend to resolve fewer appeals in consumers' favor.
? CIGNA Healthcare of Arizona has had the highest number of fines in the past five years. It had three, worth $19,000. Four companies had no fines.
? Blue Cross and Blue Shield of Arizona is the state's largest insurer. United is second.
Erin Klug, insurance department spokeswoman, said the publication would be most helpful for small businesses and individuals who are shopping for insurance.
It might also be helpful to employees who have a cafeteria-style plan that allows people to choose among insurers, she said.
The Arizona Republic
Nov. 14, 2005 12:00 AM
Arizonans can find out more details about their health insurers, thanks to a new state publication.
The Arizona Department of Insurance has released a report listing fines and complaints filed against health insurers. It also lists the number of times consumers have filed appeals against insurers' decisions.
The report looks at the performance of 27 insurers representing 75 percent of Arizona's health insurance market.
Consumers can learn:
? Of the major health insurers, United Healthcare of Arizona has the highest number of complaints per enrollee. Other smaller companies have even higher complaint ratios. They include Fortis Insurance Co., (now known as Time Insurance Co.) and Mega Life and Health Insurance Co.
? Of the major health insurers, Humana Health Plan agrees with consumers' appeals more than any other insurer. Smaller insurers such as Mega tend to resolve fewer appeals in consumers' favor.
? CIGNA Healthcare of Arizona has had the highest number of fines in the past five years. It had three, worth $19,000. Four companies had no fines.
? Blue Cross and Blue Shield of Arizona is the state's largest insurer. United is second.
Erin Klug, insurance department spokeswoman, said the publication would be most helpful for small businesses and individuals who are shopping for insurance.
It might also be helpful to employees who have a cafeteria-style plan that allows people to choose among insurers, she said.
Chambers offer health insurance savings
By Jenny Gordon
TELEGRAPH STAFF WRITER
Businesses that are members of the Warner Robins Area Chamber of Commerce now have the added value of receiving up to a 5 percent discount on group health insurance.
For the past several years the Perry Chamber has offered a discounted rate on health insurance to its business members, through an agreement with Purchasing Alliance Solutions, an employee benefits firm specializing in Chamber programs, according to Mike Jackson, chairman of the Perry Chamber.
The Warner Robins Chamber realized that they had the opportunity to offer the same discounts to its business members and approached the Perry Chamber. In the spirit of cooperation, the Perry Chamber board unanimously agreed to partner with Warner Robins in allowing the Chamber to offer the same benefits to its members.
Representatives from the Perry and Warner Robins area chambers came together last week at the Museum of Aviation to officially announce a partnership.
The health program offered to Warner Robins Chamber members is known as Purchasing Alliance Warner Robins Area. The health insurance is underwritten by Blue Cross Blue Shield of Georgia.
With rising health insurance costs, Jackson said, this was seen as an opportunity for the two Chambers to pass the benefits on to their members.
"Small and large businesses alike are looking for ways to cut their costs, and through membership through the Chambers they receive a discount on the purchase of those insurance products," said Jackson.
"It's truly a win-win program," he said.
According to Dave Adams of Purchasing Alliance, there are presently 110 Georgia chambers of commerce in the network.
The health insurance program allows Chamber members to save money on medical insurance for employees, life insurance, dental, vision and long-term and short-term disability.
"This is the first program with Chambers in one county," he said.
Warner Robins Chamber businesses interested in the group health plan can approach any local independent agent in the area who offers Blue Cross Blue Shield of Georgia.
Warner Robins has a little more than 1,100 business Chamber members, while Perry has 393 members.
TELEGRAPH STAFF WRITER
Businesses that are members of the Warner Robins Area Chamber of Commerce now have the added value of receiving up to a 5 percent discount on group health insurance.
For the past several years the Perry Chamber has offered a discounted rate on health insurance to its business members, through an agreement with Purchasing Alliance Solutions, an employee benefits firm specializing in Chamber programs, according to Mike Jackson, chairman of the Perry Chamber.
The Warner Robins Chamber realized that they had the opportunity to offer the same discounts to its business members and approached the Perry Chamber. In the spirit of cooperation, the Perry Chamber board unanimously agreed to partner with Warner Robins in allowing the Chamber to offer the same benefits to its members.
Representatives from the Perry and Warner Robins area chambers came together last week at the Museum of Aviation to officially announce a partnership.
The health program offered to Warner Robins Chamber members is known as Purchasing Alliance Warner Robins Area. The health insurance is underwritten by Blue Cross Blue Shield of Georgia.
With rising health insurance costs, Jackson said, this was seen as an opportunity for the two Chambers to pass the benefits on to their members.
"Small and large businesses alike are looking for ways to cut their costs, and through membership through the Chambers they receive a discount on the purchase of those insurance products," said Jackson.
"It's truly a win-win program," he said.
According to Dave Adams of Purchasing Alliance, there are presently 110 Georgia chambers of commerce in the network.
The health insurance program allows Chamber members to save money on medical insurance for employees, life insurance, dental, vision and long-term and short-term disability.
"This is the first program with Chambers in one county," he said.
Warner Robins Chamber businesses interested in the group health plan can approach any local independent agent in the area who offers Blue Cross Blue Shield of Georgia.
Warner Robins has a little more than 1,100 business Chamber members, while Perry has 393 members.
Alaska's student health insurance rates on the rise
By Skye Stauffer
November 15, 2005
Student health insurance at UAA is provided by Mega Life company, which works with UAA to provide health care for students.
Every five years, insurance companies give bids to UAA and UAF to have their presence on campus.
Health insurance rates at UAF have gown down due to the mandatory health insurance enrollment. Typically the more people registered for health insurance the lower the rates.
However, those at UAA are not required to have health insurance, students can still receive healthcare at the Student Health and Counseling Center.
Kristi Isaeff, manager of the student health center, said students need to understand what they?re buying before they purchase health insurance.
Students often overlook the fine print in insurance policies, Isaeff said. For instance, Mega Life Student Insurance charges a $100 deductible per insured person for every visit to health center outside of their network for up to $500 each year.
Another aspect of insurance is a clause regarding pre-existing conditions diagnosed within 12 months prior to the health insurance taking effect must pay for one year of the insurance without receiving any coverage or benefits.
The student health insurance offered at UAA costs individuals $896 each year. After the deductible is paid student health insurance will cover 80 percent of the customary charges relating to injury or sickness.
Senior James Oxford has a genetic birth defect that causes bone and neurological problems. He is uninsured and is looking forward to the possibility of being employed at the university as a staff member this spring so he can have health insurance.
Right now Oxford manages his medical bills with a medical credit account, which is a medical credit card run by the company Care Credit, but not all doctors will take it. Oxford estimates his medical expenses for 2006 at around $3,000.
?We need some kind of national health care system that covers people under 24 so that they have a chance to graduate and get out in the work force instead of worrying about paying expenses for medical care,? Oxford said.
There are several types of health insurance plans sold as group and individual health insurance, but health insurance benefits vary from policy to policy.
UAA Grad student Laura Cronick, school nurse at the King Career Center, thinks health insurance rates are out of control, but said Denali KidCare is a good health program for students who are young mothers.
?Health Insurance can render people bankrupt,? Cronick said. ?It?s a vicious cycle.?
November 15, 2005
Student health insurance at UAA is provided by Mega Life company, which works with UAA to provide health care for students.
Every five years, insurance companies give bids to UAA and UAF to have their presence on campus.
Health insurance rates at UAF have gown down due to the mandatory health insurance enrollment. Typically the more people registered for health insurance the lower the rates.
However, those at UAA are not required to have health insurance, students can still receive healthcare at the Student Health and Counseling Center.
Kristi Isaeff, manager of the student health center, said students need to understand what they?re buying before they purchase health insurance.
Students often overlook the fine print in insurance policies, Isaeff said. For instance, Mega Life Student Insurance charges a $100 deductible per insured person for every visit to health center outside of their network for up to $500 each year.
Another aspect of insurance is a clause regarding pre-existing conditions diagnosed within 12 months prior to the health insurance taking effect must pay for one year of the insurance without receiving any coverage or benefits.
The student health insurance offered at UAA costs individuals $896 each year. After the deductible is paid student health insurance will cover 80 percent of the customary charges relating to injury or sickness.
Senior James Oxford has a genetic birth defect that causes bone and neurological problems. He is uninsured and is looking forward to the possibility of being employed at the university as a staff member this spring so he can have health insurance.
Right now Oxford manages his medical bills with a medical credit account, which is a medical credit card run by the company Care Credit, but not all doctors will take it. Oxford estimates his medical expenses for 2006 at around $3,000.
?We need some kind of national health care system that covers people under 24 so that they have a chance to graduate and get out in the work force instead of worrying about paying expenses for medical care,? Oxford said.
There are several types of health insurance plans sold as group and individual health insurance, but health insurance benefits vary from policy to policy.
UAA Grad student Laura Cronick, school nurse at the King Career Center, thinks health insurance rates are out of control, but said Denali KidCare is a good health program for students who are young mothers.
?Health Insurance can render people bankrupt,? Cronick said. ?It?s a vicious cycle.?
Health insurance law for children
Chicago -- Gov. Rod Blagojevich signed a measure on Tuesday intended to allow all children in Illinois, including those in working-class and middle-class families, to obtain health insurance.
National experts on health care said the new law, which would offer discounts on premiums for those who qualify, was the broadest plan to insure children by any state.
Political leaders in other states, the experts said, are certain to be watching whether Illinois succeeds in expanding coverage to its 250,000 children who are now uninsured, about half of whom are not from the poorest families but from families earning more than $40,000 a year.
Blagojevich, a Democrat, said he hoped that the move would lead the way for a nation that needs to face a growing problem of middle-income families who cannot afford insurance premiums.
Critics of the program, which the governor says will cost the state $45 million in its first year, said they feared that such a sweeping offer could end up costing far more at a time when the state's budget is strained and might turn Illinois into a refuge for families from other states desperate to insure their children.
Aides to Blagojevich said that the program, known as All Kids, was meticulously detailed and would work. Families who earn too much to be eligible for the existing state and federally financed health programs, including the widely available KidCare, may buy into the new plan.
The state costs, the aides said, will be paid for by shifting the management of 1.7 million Medicaid recipients. Those patients will no longer go to any doctor on a list of eligible doctors but to a single physician who will work on more problems earlier, saving an estimated $56 million the first year.
A family's costs for All Kids will depend on the household income. A family of four earning $41,000 a year will pay $40 a month for one child or $80 a month for two or more children. The co-payment for doctors' visits will be $10 each. A family of four earning $61,000 to $79,000 will pay $70 for one child and $140 for two or more children. The co-payment will be $15.
People with higher incomes and without insurance also are eligible, though the premiums increase significantly.
Other states have tackled the same issue, but none has settled on a program as sweeping or comprehensive as the Illinois law, according to Diane Rowland, executive vice president of the Kaiser Family Foundation, a health research group.
In California last month, Gov. Schwarzenegger vetoed a bill that would have provided access to coverage for all uninsured children in the state, saying he believed that children should be insured but that the bill failed to detail how to pay for the plan.
Massachusetts has a similar but less extensive plan than Illinois, a comparison shows. Although Massachusetts offers coverage to all children, the coverage is limited for benefits such as prescription medicines, eyeglasses, hearing aids, and mental health and substance abuse services.
National experts on health care said the new law, which would offer discounts on premiums for those who qualify, was the broadest plan to insure children by any state.
Political leaders in other states, the experts said, are certain to be watching whether Illinois succeeds in expanding coverage to its 250,000 children who are now uninsured, about half of whom are not from the poorest families but from families earning more than $40,000 a year.
Blagojevich, a Democrat, said he hoped that the move would lead the way for a nation that needs to face a growing problem of middle-income families who cannot afford insurance premiums.
Critics of the program, which the governor says will cost the state $45 million in its first year, said they feared that such a sweeping offer could end up costing far more at a time when the state's budget is strained and might turn Illinois into a refuge for families from other states desperate to insure their children.
Aides to Blagojevich said that the program, known as All Kids, was meticulously detailed and would work. Families who earn too much to be eligible for the existing state and federally financed health programs, including the widely available KidCare, may buy into the new plan.
The state costs, the aides said, will be paid for by shifting the management of 1.7 million Medicaid recipients. Those patients will no longer go to any doctor on a list of eligible doctors but to a single physician who will work on more problems earlier, saving an estimated $56 million the first year.
A family's costs for All Kids will depend on the household income. A family of four earning $41,000 a year will pay $40 a month for one child or $80 a month for two or more children. The co-payment for doctors' visits will be $10 each. A family of four earning $61,000 to $79,000 will pay $70 for one child and $140 for two or more children. The co-payment will be $15.
People with higher incomes and without insurance also are eligible, though the premiums increase significantly.
Other states have tackled the same issue, but none has settled on a program as sweeping or comprehensive as the Illinois law, according to Diane Rowland, executive vice president of the Kaiser Family Foundation, a health research group.
In California last month, Gov. Schwarzenegger vetoed a bill that would have provided access to coverage for all uninsured children in the state, saying he believed that children should be insured but that the bill failed to detail how to pay for the plan.
Massachusetts has a similar but less extensive plan than Illinois, a comparison shows. Although Massachusetts offers coverage to all children, the coverage is limited for benefits such as prescription medicines, eyeglasses, hearing aids, and mental health and substance abuse services.
Subscribe to:
Comments (Atom)
:.
